Buckling of the Tethering Catheter causes Migration of a Temporary Caval Filter to the Right Atrium

Kelly, Ian; Boyd, Christopher S.

doi:10.1053/crad.1999.0206

Cited by 26 publications

(14 citation statements)

References 12 publications

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“…A number of general limitations occur in different catheter types, regardless of their level of steerability, as a result of co-play between catheter components with each other as well as with the tortuous vasculature and dynamic cardiac environment. Some effects are the result of torque and push force application, 22,23 whereas others are influenced by the cable actuation and material choice, 24 or internal friction between the catheter and the cables. These effects further complicate steering.…”

Section: Introductionmentioning

confidence: 99%

Catheter steering in interventional cardiology: Mechanical analysis and novel solution

Ali

Sakes

Arkenbout

et al. 2019

Proc Inst Mech Eng H

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In recent years, steerable catheters have been developed to combat the effects of the dynamic cardiac environment. Mechanically actuated steerable catheters appear the most in the clinical setting; however, they are bound to a number of mechanical limitations. The aim of this research is to gain insight in these limitations and use this information to develop a new prototype of a catheter with increased steerability. The main limitations in mechanically steerable catheters are identified and analysed, after which requirements and solutions are defined to design a multi-steerable catheter. Finally, a prototype is built and a proof-of-concept test is carried out to analyse the steering functions. The mechanical analysis results in the identification of five limitations: (1) low torsion, (2) shaft shortening, (3) high unpredictable friction, (4) coupled tip-shaft movements, and (5) complex cardiac environment. Solutions are found to each of the limitations and result in the design of a novel multi-steerable catheter with four degrees of freedom. A prototype is developed which allows the dual-segmented tip to be steered over multiple planes and in multiple directions, allowing a range of complex motions including S-shaped curves and circular movements. A detailed analysis of limitations underlying mechanically steerable catheters has led to a new design for a multi-steerable catheter for complex cardiac interventions. The four integrated degrees of freedom provide a high variability of tip directions, and repetition of the bending angle is relatively simple and reliable. The ability to steer inside the heart with a variety of complex shaped curves may potentially change conventional approaches in interventional cardiology towards more patient-specific and lower complexity procedures. Future directions are headed towards further design optimizations and the experimental validation of the prototype.

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Section: Introductionmentioning

confidence: 99%

Catheter steering in interventional cardiology: Mechanical analysis and novel solution

Ali

Sakes

Arkenbout

et al. 2019

Proc Inst Mech Eng H

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“…If the filter moves into the heart, simply removing the filter by drawing a tethering catheter runs the risk of serious damage to the cardiac musculature 7 . Eight cases of temporary filter migration into the heart have been reported so far and in two case the patients died, one as a result of cardiac tamponade and the other as a result of secondary pulmonary artery thrombosis 7–10 . Although the dislocated filter was successfully removed in the current case, physicians should be aware of the risk of unexpected migration when applying temporary filters to patients with intracaval tumor thrombi.…”

Section: Discussionmentioning

confidence: 83%

“…7 Eight cases of temporary filter migration into the heart have been reported so far and in two case the patients died, one as a result of cardiac tamponade and the other as a result of secondary pulmonary artery thrombosis. [7][8][9][10] Although the dislocated filter was successfully removed in the current case, physicians should be aware of the risk of unexpected migration when applying temporary filters to patients with intracaval tumor thrombi. So what can we do to minimize accidental dislocation of an IVC filter?…”

Section: Discussionmentioning

confidence: 86%

Accidental dislocation of an intracaval temporary filter into the heart in a case of renal cell carcinoma extending into the vena cava

et al. 2006

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“…While the initial experience with the first-generation device (Tempofilter I) has been positive (5), several episodes of filter migration to the right atrium due to catheter buckling, one of which was fatal, have suspended further development of this filter (2, 3). The problems related to structural stability were resolved by significant modifications of the filter cone and the tethering catheter.…”

Section: Discussionmentioning

confidence: 99%

Fracture of a Tempofilter II: an Initial Case Report

et al. 2011

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Tempofilter II is a device that is used for pulmonary embolism prophylaxis. Since the appearance of the Tempofilter II following withdrawal of the Tempofilter I, it has been reported that the Tempofilter II is safe, effective and useful. Here we report on the first case of a fracture of one leg of the filter and this leg was embedded in the inferior vena cava wall in a 62-year-old man with deep vein thrombosis.

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Buckling of the Tethering Catheter causes Migration of a Temporary Caval Filter to the Right Atrium

Cited by 26 publications

References 12 publications

Catheter steering in interventional cardiology: Mechanical analysis and novel solution

Catheter steering in interventional cardiology: Mechanical analysis and novel solution

Accidental dislocation of an intracaval temporary filter into the heart in a case of renal cell carcinoma extending into the vena cava

Fracture of a Tempofilter II: an Initial Case Report

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