scholarly journals In vivo evaluation of a new vena cava filter

2016 ◽  
Vol 15 (2) ◽  
pp. 99-105
Author(s):  
Gilberto do Nascimento Galego ◽  
Pierre Galvagni Silveira ◽  
Júlia Jochen Broering ◽  
Eduardo da Silva Eli ◽  
Marcelo Peixer Corbellini ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Cardiovascular Death ◽  
Tissue Response ◽  
Vena Cava Filter ◽  
Pathological Examination ◽  
In Vivo Evaluation ◽  
Vena Cava Filters

Abstract Background Pulmonary embolism is an important cause of cardiovascular death. Inferior vena cava filters have been shown to be effective for prevention of this condition. Objectives To determine the safety, performance and efficacy of a new inferior vena cava filter in an ovine model. Methods BKone1 filters are self-centering with over-the-wire deployment, have three filtering regions and are made from nickel-titanium alloy. Eight of these filters were implanted in 8 sheep. The sheep were divided into 4 groups of two animals (A and B) and the number of clots injected differed by group. Two clots were injected in group 2, four in group 3, eight in group 4 and zero clots in group 1. A animals underwent euthanasia soon after the procedure and B animals were observed for 30 days and then euthanized after a control cavography. All inferior vena cavas were processed for histological examination. Clots were prepared in a metal mold, sectioned and then radiopaque markers were inserted. Clot capture was analyzed by identifying the radiopaque marker on fluoroscopy. Results No clot migration was observed during follow-up. Control cavographies showed patent inferior vena cavas. Pathological examination indicated little inflammatory tissue response. All clots were captured in the condition with 2 clots, only one clot was missed in the group injected with 4 clots and in the condition of 8 clots, they were partly captured. Conclusions The filters were deployed safely. There was a reduction in efficacy as the number of blood clots increased.

A New Self-Convertible Inferior Vena Cava Filter: Experimental In-vitro and In-vivo Evaluation

2011 ◽  
Vol 22 (6) ◽  
pp. 829-834 ◽  
Author(s):  
XiXiang Gao ◽  
Jian Zhang ◽  
Bing Chen ◽  
HengXi Yu ◽  
JianXin Li ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
In Vivo Evaluation

scholarly journals The use of retrievable inferior vena cava filters in pregnancy: Another successful case report, but are we actually making a difference?

2016 ◽  
Vol 9 (3) ◽  
pp. 102-105 ◽  
Author(s):  
Lodewyk E Du Plessis ◽  
Ben W Mol ◽  
John M Svigos
Keyword(s):  
Venous Thromboembolism ◽  
Mortality Rate ◽  
Inferior Vena Cava ◽  
Risk Reduction ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters

Background Pregnant women with venous thromboembolism are traditionally managed with anticoagulation, but inferior vena cava filters are an alternative. We balanced risks and benefits of an inferior vena cava filter in a decision analysis. Methods We constructed a decision model to compare in pregnant women with VTE the outcome of (1) inferior vena cava filter and anticoagulant treatment versus (2) anticoagulant treatment only. Results Assuming a 63% risk reduction from an inferior vena cava filter (baseline mortality rate of venous thromboembolism of 0.5%), 318 women would need to be treated with inferior vena cava filters to prevent one venous thromboembolism related maternal death. Sensitivity analyses indicated that at a mortality rate of 0.5% the risk reduction from inferior vena cava filters needed to be 80%, while at a mortality rate of 2% a risk reduction of 20% would justify inferior vena cava filters. Conclusions In view of their potential morbidity, inferior vena cava filters should be restricted to pregnant woman at strongly increased risk of recurrent venous thromboembolism.

Inferior Vena Cava Filter Evaluation and Management for the Diagnostic Radiologist: A Comprehensive Review Including Inferior Vena Cava Filter-Related Complications and PRESERVE Trial Filters

2019 ◽  
Vol 70 (4) ◽  
pp. 367-382 ◽  
Author(s):  
Osman Ahmed ◽  
Shermeen Sheikh ◽  
Patrick Tran ◽  
Brian Funaki ◽  
Alexandria M. Shadid ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Cross Sectional ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters ◽  
Cross Sectional Imaging

Inferior vena cava filters are commonly encountered devices on diagnostic imaging that were highlighted in a 2010 Food and Drug Administration safety advisory regarding their complications from long-term implantation. The Predicting the Safety and Effectiveness of Inferior Vena Cava Filters (PRESERVE) trial is an ongoing after-market study investigating the safety and utility of commonly utilized filters in practice today. While most of these filters are safe, prompt recognition and management of any filter-associated complication is imperative to prevent or reduce the morbidity and mortality associated with them. This review is aimed at discussing the appropriate utilization and placement of inferior vena cava filters in addition to the recognition of filter-associated complications on cross-sectional imaging. An overview of the PRESRVE trial filters is also provided to understand each filter's propensity for specific complications.

scholarly journals Prophylactic placement of inferior vena cava filters and the risk of death or venous thromboembolism in severe trauma patients: a retrospective study comparing two hospitals with different approaches

2021 ◽  
Vol 10 (3) ◽  
pp. 205846012199934
Author(s):  
Thien Trung Tran ◽  
Haraldur Bjarnason ◽  
Jennifer McDonald ◽  
Nils Oddvar Skaga ◽  
Damon E Houghton ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Filter Placement ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters

Background Prophylactic use of inferior vena cava filters to prevent pulmonary embolism in trauma is controversial. The practice varies between hospitals and countries, in part due to conflicting evidence and guidelines. Purpose To compare the effects of pulmonary embolism, deep venous thrombosis and mortality in two hospitals using prophylactic inferior vena cava filter placement or prophylactic anticoagulation alone. Material and Methods Patients presenting with severe trauma were recruited from two level-1 trauma centres between January 2008 and December 2013. Recruited patients from an US hospital having prophylactic inferior vena cava filter inserted were compared to a Scandinavian hospital using prophylactic anticoagulation alone. Inclusion criteria were age >15 years, Injury Severity Score >15 and survival >24 h after hospital admission. Patients with venous thromboembolism diagnosed prior to inferior vena cava filter placement were excluded. A Cox proportional hazard regression model was used with adjustment for immortal time bias and predictor variables. Results In total, 951 patients were reviewed, 282 from an US hospital having inferior vena cava filters placed and 669 from a Scandinavian hospital without inferior vena cava filters. The mean age was 45.9 vs. 47.4 years and the mean Injury Severity Score was 29.8 vs. 25.9, respectively. Inferior vena cava filter placement was not associated with the hazard of pulmonary embolism (Hazard ratio=0.43; 95% confidence interval (CI) 0.12, 1.45; P=0.17) or mortality (Hazard ratio=1.16; 95% CI 0.70, 1.95; P=0.56). However, an increased rate of deep venous thrombosis was observed with inferior vena cava filters in place (Hazard ratio=3.75; 95% CI 1.68, 8.36; P=0.001). Conclusion In severely injured trauma patients, prophylactic inferior vena cava filter placement was not associated with pulmonary embolism or mortality. However, inferior vena cava filters were associated with increased rate of deep venous thrombosis.

Numerical Analysis of the Hemodynamics and Embolus Capture of a Greenfield Vena Cava Filter

2005 ◽  
Vol 128 (3) ◽  
pp. 360-370 ◽  
Author(s):  
T. N. Swaminathan ◽  
Howard H. Hu ◽  
Aalpen A. Patel
Keyword(s):  
Shear Stress ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Central Hole ◽  
Stagnation Zone ◽  
Greenfield Filter ◽  
Vena Cava Filters ◽  
Different Characteristics

Background: Vena Cava filters are used to prevent pulmonary embolism in patients with deep vein thrombosis who are unresponsive to anticoagulation therapy. Various filter designs exist in the market with different characteristics distinguishing them. An understanding of the characteristics of these filters is desirable in order to develop better designs. Methods: A computational fluid dynamical study of the flow over an unoccluded stainless steel Greenfield Vena Cava filter (Boston Scientific, Watertown, MA) to determine its properties has been performed. Simulation of flow over a filter placed axisymmetrically in a rounded inferior vena cava has been performed at a Reynolds numbers of 1000 and the consequences of the flow (by studying parameters like shear stress and stagnation zones) have been discussed. Furthermore, a new finite element based numerical method has been developed that allows the study of capturing properties of Inferior Vena Cava filters. The key idea is the introduction of a thin-wire-model (TWM) that enables a drastic reduction in the computational cost while still maintaining control on the physics of the problem. This numerical technique has been applied to evaluate the embolus capture characteristic of a Greenfield filter. Results: The flow around the unoccluded filter is found to be steady and laminar at the conditions studied. A recirculation/stagnation zone develops immediately downstream of the filter head. This zone is significantly larger when the central hole is occluded. The shear stress and stagnation zone properties for such a flow over a Greenfield filter are compared with existing literature (in vitro studies). A graph showing the regions wherein clots escape or get captured has been determined by a means of numerical simulations. The data has further been analyzed to determine the probability of clot capture as function of the clot size. Conclusions: The stagnation zone formed behind the head of the Greenfield filter is found to be smaller in size when compared to that of the same filter with the central hole occluded. A map of the shear stress distribution shows a small region having the potential for thrombogenesis. The non-Newtonian properties of blood are not seen to cause much variation in the flow field when compared to the Newtonian model. However variation in the cava size leads to a significant change in the shear stresses. This study also establishes a novel method wherein computational means are used to determine the efficacy of clot capturing of filters. These techniques can further be used to compare the different characteristics among filters.

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