Pulmonary infarction with an inferior vena cava filter

  Pulmonary embolism (PE) is a general term for a group of clinical and pathophysiological syndromes in which various endogenous or exogenous emboli obstruct the pulmonary arteries and cause pulmonary circulation disorders, including pulmonary thromboembolism, fat embolism syndrome, amniotic fluid embolism, air embolism, etc. The clinical manifestations are chest tightness, shortness of breath, dyspnea, chest pain, low-grade fever, and coughing up blood. It has sudden onset, fierce onset, critical condition and high mortality rate. One of the most common pulmonary infarction is pulmonary thromboembolism, and most of the thromboembolism comes from the deep vein thrombosis of lower limbs. Statistics in the United States show that 79% of patients with pulmonary embolism have evidence of lower extremity deep vein thrombosis (DVT), and 50% of patients with proximal DVT have pulmonary thromboembolism. Because PE and DVT are interrelated in their pathogenesis, research now considers them to be different clinical manifestations of the same disease, at different sites of onset and in different stages, and therefore collectively referred to as venous thromboembolic disease (VTE). Recent studies suggest that approximately millions of patients with VTE are diagnosed each year worldwide. The number of fatal and non-fatal VTE cases in the United States exceeds 900,000 per year, with approximately 296,400 deaths, the third highest mortality rate among all diseases, after malignancy and myocardial infarction, and the remaining non-fatal VTE cases include 376,400 DVT and 237,100 PE. , pulmonary embolism has become a recognized common cardiovascular disease. Epidemiological studies have shown that venous thromboembolism VTE is one of the major causes of death and disability in hospitalized patients. the onset of PE is sudden, the clinical diagnosis rate is low, and less than half of the cases of fatal PE are diagnosed at the time of death.  Therefore, prompt and early measures are needed to prevent the occurrence of PE in patients with VTE in clinical practice. The introduction of inferior vena cava filters provided a means to prevent pulmonary embolism. Trousseau proposed in 1868 that blocking the vena cava could prevent pulmonary embolism, the first case of inferior vena cava ligation to prevent pulmonary embolism was reported in 1893, and the first percutaneous inferior vena cava filter was created in 1967. The vena cava filter itself does not treat DVT, but it can prevent the occurrence of pulmonary embolism due to DVT, especially the possibility of pulmonary embolism due to thrombus dislodgement during thrombolysis. The use of inferior vena cava filters has reduced the incidence of PE due to DVT thrombus dislodgement from 60% to 70% to 0.19% to 5%. The placement of the filter is done through a minimally invasive interventional approach, which has the advantages of minimal trauma and rapid postoperative recovery. For patients with absolute indications this procedure has been considered the only effective method to prevent fatal PE, and has been increasingly used in recent years and will provide life protection for more and more VTE patients.