In Vitro Studies of Temporary Vena Cava Filters

SUMMARYWe report a rescued 37-year-old woman in her 30 th week of gestation with massive pulmonary thromboembolism who was admitted to our cardiac care unit with progressive dyspnea and 2 episodes of syncope. Helical chest CT showed massive pulmonary thromboembolism of both pulmonary arteries. Although 26,000 U/day of heparin was administered following insertion of a temporary filter, hemodynamic evaluation documented no improvement. Since pulmonary artery (PA) pressure increased from 62/22 mmHg to 80/ 24 mmHg just after an emergency cesarean section on day 2, an emergency transcatheter thrombectomy was performed and it showed decreased PA pressure following extensive thrombus aspiration. Mother and baby were discharged with no complications.(Int Heart J 2007; 48: [269][270][271][272][273][274][275][276]

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“…14) Even small thrombi may cause symptoms and even death if they reach a previously compromised lung.…”

Section: Discussionmentioning

confidence: 99%

Massive Pulmonary Thromboembolism in Pregnancy Rescued Using Transcatheter Thrombectomy

et al. 2007

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“…Inferior vena cava (IVC) filters have been used to prevent recurrent PE in patients who are unresponsive to anticoagulation therapy or in who anticoagulation is contraindicated1. Although VCFs have been widely used in clinics, they still may endure major failures due to the buildup of thrombus in the filters themselves after deployment2.…”

mentioning

confidence: 99%

Improvement of hemodynamic performance using novel helical flow vena cava filter design

Chen

Zhang

Deng

et al. 2017

Sci Rep

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We propose a vena cava filter in which helical flow is created in the filter’s working zone to minimize filter blockage by trapped clots and facilitate the lysis of trapped clots. To validate this new design, we compared five helical flow inducers with different thread pitches in terms of blood flow patterns in the filter. The vena cava was reconstructed based on computed tomography images. Both the numerical simulation and in vitro experiment revealed that the helical flow inducer can effectively create a helical flow in the vessel, thereby subduing the filter structure’s adverse disruption to blood flow, and increasing flow-induced shear stress in the filter center. In addition, the smaller thread pitch helical flow inducer reduced the oscillating shear index and relative residence time on the vessel wall. Moreover, we observed that the helical flow inducer in the vena cava could induce flow rotation both in clockwise and counterclockwise directions. In conclusion, the new design of the filter with the smaller thread pitch inducer is advantageous over the traditional filter in terms of improving local hemodynamics, which may reduce thrombosis build-up after deployment.

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“…[6][7][8][9][10][11][12][13] Effectiveness of permanent and retrievable filters in thrombus capture has been evaluated in experimental and clinical studies. [7][8][9][10][11][12][13][14][15][16][17][18][19] In one in vitro series, 16 retrievable filters were more effective in trapping thrombus compared to permanent devices, especially when small thrombi were considered. So far, no long-term studies of nonretrieved Gü nther Tulip filters have been published.…”

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confidence: 99%

Clinical Experience with Retrievable Günther Tulip Vena Cava Filters

Wicky¹,

Doenz²,

Meuwly³

et al. 2003

J Endovasc Ther

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In Vitro Studies of Temporary Vena Cava Filters

Abstract: The vena cava flow model demonstrates significant differences in rates of clot capture (range 22%-98%) depending on cava diameter, thrombus size, and filter type.

Cited by 23 publications

References 10 publications

Massive Pulmonary Thromboembolism in Pregnancy Rescued Using Transcatheter Thrombectomy

Massive Pulmonary Thromboembolism in Pregnancy Rescued Using Transcatheter Thrombectomy

Improvement of hemodynamic performance using novel helical flow vena cava filter design

Clinical Experience with Retrievable Günther Tulip Vena Cava Filters

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