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Wang X, Wang H, Qian H, Su H, Lou D, Tian L, Chen D, Ding H, Fan F. Design and performance analysis of a new inferior vena cava filter. Comput Methods Biomech Biomed Engin 2024:1-13. [PMID: 38461446 DOI: 10.1080/10255842.2024.2326084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/24/2024] [Indexed: 03/12/2024]
Abstract
This study proposes a novel inferior vena cava filter (IVCF) design, "Lotus," aiming to enhance release stability and endothelialization. A catheter-filter-vessel model was established for IVCF property analysis, validated by comparing numerical simulations and in vitro tests. Lotus's mechanical properties were analyzed, and optimization suggestions are provided. Compared to existing clinical filters, Lotus demonstrates improved release stability and thrombus capture ability. This work suggests Lotus as a potential technical reference for improved IVCF treatment.
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Affiliation(s)
- Xianying Wang
- Department of Civil Engineering, Harbin Institute of Technology at Weihai, Weihai, Shandong, China
| | - Huajie Wang
- Department of Civil Engineering, Harbin Institute of Technology at Weihai, Weihai, Shandong, China
| | - Hongliang Qian
- Department of Civil Engineering, Harbin Institute of Technology at Weihai, Weihai, Shandong, China
| | - Hongdong Su
- Shandong Weigao Intervention Medical Technology Co.Ltd, Weihai, Shandong, China
- Department of Research and Development, Shangdong Visee Medical Device, Weihai, Shandong, China
| | - Deda Lou
- Shenzhen Chuangxin Medical Technology Co,.Ltd, Shenzhen, Guangdong, China
| | - Lijian Tian
- Shandong Weigao Intervention Medical Technology Co.Ltd, Weihai, Shandong, China
- Department of Research and Development, Shangdong Visee Medical Device, Weihai, Shandong, China
| | - Deshen Chen
- Department of Civil Engineering, Harbin Institute of Technology at Weihai, Weihai, Shandong, China
| | - Huafang Ding
- Department of Research and Development, Shangdong Visee Medical Device, Weihai, Shandong, China
| | - Feng Fan
- Department of Civil Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, China
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Riley JM, Price NS, Saaid HM, Good BC, Aycock KI, Craven BA, Manning KB. In Vitro Clot Trapping Efficiency of the FDA Generic Inferior Vena Cava Filter in an Anatomical Model: An Experimental Fluid-Structure Interaction Benchmark. Cardiovasc Eng Technol 2021; 12:339-352. [PMID: 33683671 DOI: 10.1007/s13239-021-00524-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/08/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Robust experimental data for performing validation of fluid-structure interaction (FSI) simulations of the transport of deformable solid bodies in internal flow are currently lacking. This in vitro experimental study characterizes the clot trapping efficiency of a new generic conical-type inferior vena cava (IVC) filter in a rigid anatomical model of the IVC with carefully characterized test conditions, fluid rheological properties, and clot mechanical properties. METHODS Various sizes of spherical and cylindrical clots made of synthetic materials (nylon and polyacrylamide gel) and bovine blood are serially injected into the anatomical IVC model under worst-case exercise flow conditions. Clot trapping efficiencies and their uncertainties are then quantified for each combination of clot shape, size, and material. RESULTS Experiments reveal the clot trapping efficiency increases with increasing clot diameter and length, with trapping efficiencies ranging from as low as approximately 42% for small 3.2 mm diameter spherical clots up to 100% for larger clot sizes. Because of the asymmetry of the anatomical IVC model, the data also reveal the iliac vein of clot origin influences the clot trapping efficiency, with the trapping efficiency for clots injected into the left iliac vein up to a factor of 7.5 times greater than that for clots injected into the right iliac (trapping efficiencies of approximately 10% versus 75%, respectively). CONCLUSION Overall, this data set provides a benchmark for validating simulations predicting IVC filter clot trapping efficiency and, more generally, low-Reynolds number FSI modeling.
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Affiliation(s)
- J M Riley
- Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA, 16802, USA
| | - N S Price
- Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA, 16802, USA
| | - H M Saaid
- Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA, 16802, USA
| | - B C Good
- Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA, 16802, USA
| | - K I Aycock
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, USA
| | - B A Craven
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, USA
| | - K B Manning
- Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA, 16802, USA. .,Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA.
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Comparison between various regression depth methods and the support vector machine to approximate the minimum number of misclassifications. Comput Stat 2019. [DOI: 10.1007/s001800200106] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Boonstra PS, Barbaro RP, Sen A. Default Priors for the Intercept Parameter in Logistic Regressions. Comput Stat Data Anal 2019; 133:245-256. [PMID: 31530966 PMCID: PMC6748335 DOI: 10.1016/j.csda.2018.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In logistic regression, separation occurs when a linear combination of predictors perfectly discriminates the binary outcome. Because finite-valued maximum likelihood parameter estimates do not exist under separation, Bayesian regressions with informative shrinkage of the regression coefficients offer a suitable alternative. Classical studies of separation imply that efficiency in estimating regression coefficients may also depend upon the choice of intercept prior, yet relatively little focus has been given on whether and how to shrink the intercept parameter. Alternative prior distributions for the intercept are proposed that downweight implausibly extreme regions of the parameter space, rendering regression estimates that are less sensitive to separation. Through simulation and the analysis of exemplar datasets, differences across priors stratified by established statistics measuring the degree of separation are quantified. Relative to diffuse priors, these proposed priors generally yield more efficient estimation of the regression coefficients themselves when the data are nearly separated. They are equally efficient in non-separated datasets, making them suitable for default use. Modest differences were observed with respect to out-of-sample discrimination. These numerical studies also highlight the interplay between priors for the intercept and the regression coefficients: findings are more sensitive to the choice of intercept prior when using a weakly informative prior on the regression coefficients than an informative shrinkage prior.
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Affiliation(s)
| | - Ryan P. Barbaro
- Division of Pediatric Critical Care, University of Michigan, Ann Arbor, USA
- Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, USA
| | - Ananda Sen
- Department of Biostatistics, University of Michigan, Ann Arbor, USA
- Department of Family Medicine, University of Michigan, Ann Arbor, USA
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Robinson RA, Herbertson LH, Sarkar Das S, Malinauskas RA, Pritchard WF, Grossman LW. Limitations of using synthetic blood clots for measuring in vitro clot capture efficiency of inferior vena cava filters. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2013; 6:49-57. [PMID: 23690701 PMCID: PMC3656916 DOI: 10.2147/mder.s42555] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was first to evaluate the clot capture efficiency and capture location of six currently-marketed vena cava filters in a physiological venous flow loop, using synthetic polyacrylamide hydrogel clots, which were intended to simulate actual blood clots. After observing a measured anomaly for one of the test filters, we redirected the focus of the study to identify the cause of poor clot capture performance for large synthetic hydrogel clots. We hypothesized that the uncharacteristic low clot capture efficiency observed when testing the outlying filter can be attributed to the inadvertent use of dense, stiff synthetic hydrogel clots, and not as a result of the filter design or filter orientation. To study this issue, sheep blood clots and polyacrylamide (PA) synthetic clots were injected into a mock venous flow loop containing a clinical inferior vena cava (IVC) filter, and their captures were observed. Testing was performed with clots of various diameters (3.2, 4.8, and 6.4 mm), length-to-diameter ratios (1:1, 3:1, 10:1), and stiffness. By adjusting the chemical formulation, PA clots were fabricated to be soft, moderately stiff, or stiff with elastic moduli of 805 ± 2, 1696 ± 10 and 3295 ± 37 Pa, respectively. In comparison, the elastic moduli for freshly prepared sheep blood clots were 1690 ± 360 Pa. The outlying filter had a design that was characterized by peripheral gaps (up to 14 mm) between its wire struts. While a low clot capture rate was observed using large, stiff synthetic clots, the filter effectively captured similarly sized sheep blood clots and soft PA clots. Because the stiffer synthetic clots remained straight when approaching the filter in the IVC model flow loop, they were more likely to pass between the peripheral filter struts, while the softer, physiological clots tended to fold and were captured by the filter. These experiments demonstrated that if synthetic clots are used as a surrogate for animal or human blood clots for in vitro evaluation of vena cava filters, the material properties (eg, elastic modulus) and dynamic behavior of the surrogate should first be assessed to ensure that they accurately mimic an actual blood clot within the body.
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Affiliation(s)
- Ronald A Robinson
- Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD, USA
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Stewart SFC, Robinson RA, Nelson RA, Malinauskas RA. Effects of Thrombosed Vena Cava Filters on Blood Flow: Flow Visualization and Numerical Modeling. Ann Biomed Eng 2008; 36:1764-81. [DOI: 10.1007/s10439-008-9560-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Accepted: 08/28/2008] [Indexed: 10/21/2022]
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Mahnken AH, Pfeffer J, Stanzel S, Mossdorf A, Günther RW, Schmitz-Rode T. In Vitro Evaluation of Optionally Retrievable and Permanent IVC Filters. Invest Radiol 2007; 42:529-35. [PMID: 17568276 DOI: 10.1097/rli.0b013e318036b42b] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To systematically evaluate different optionally retrievable and permanent inferior vena cava (IVC)-filters with respect to their capture rates. MATERIAL AND METHODS Seven optionally retrievable and permanent IVC filters were tested in an in vitro flow model with a tube size of 22 mm in horizontal and vertical positions. To analyze the capture efficiency the IVC filters were implanted in concentric and eccentric positions and subsequently exposed to single and multiple blood clots of different sizes (3x5, 3x10, 5x10, 5x20, 7x20, 10x24 mm). Capture rates and pressure changes were measured and compared between the different IVC filters. RESULTS There were significant differences between the tested IVC filters. In general, the capture rate improved with increasing clot size (P<0.0001). In the single-clot exposure the highest mean capture rate was achieved with the Celect filter (90.4%+/-15.7%), whereas the Günther Tulip filter achieved best results in the multi-clot exposure (76.7%+/-12.5%). Capture rates differed significantly between the various IVC filters (single-clot: P<0.0001; multi-clot: P=0.0016). The position (horizontal or vertical) did not show a significant influence, whereas capture rates significantly decreased in the multi-clot test with eccentric filter positions (P=0.0299). In this study optionally retrievable IVC filters were more efficient than the tested permanent IVC filters (single-clot: P<0.0001; multi-clot: P=0.0002). CONCLUSIONS Optionally retrievable IVC filters are efficient. Clot size, IVC filter type, and position significantly influence capture rate. Deliberate selection of the most efficient IVC filter and concentric positioning are important to ensure optimal results.
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Affiliation(s)
- Andreas H Mahnken
- Applied Medical Engineering, Helmholtz Institute, Department of Diagnostic Radiology, RWTH Aachen University, Germany.
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Vrachliotis TG, Rabkin DJ, Berbaum K, Lang EV. Impact of unilateral common iliac vein occlusion on trapping efficacy of the Greenfield filter: an in vitro study. Acad Radiol 2001; 8:494-500. [PMID: 11394542 DOI: 10.1016/s1076-6332(03)80621-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study was to assess the effect of unilateral common iliac vein occlusion on the capturing efficacy of the Greenfield filter in vitro. MATERIALS AND METHODS A stainless steel over-the-wire Greenfield filter was placed in the Silastic inferior vena cava module of a pulsatile circuit. Three 30-mm blood clots in sets of five were injected through the module's right iliac limb with the circuit in four experimental conditions: vertical position, both iliac limbs patent (VP); vertical position, left iliac limb occluded (VOC); horizontal position, both iliac limbs patent (HP); and horizontal position, left iliac limb occluded (HOC). Each experiment was repeated 15 times, resulting in 75 clots per condition and a total of 300 clot introductions. RESULTS Clot trapping efficacy was 36 of 75 (48%) for VP, 41 of 75 (55%) for VOC, 32 of 75 (43%) for HP, and 26 of 75 (35%) for HOC. Cross comparisons of the four conditions revealed a marginally significant difference (P = .0138 with a corrected test-wise alpha = .0125) only between horizontal and vertical positions with unilateral common iliac limb occlusion. CONCLUSION Unilateral common iliac vein occlusion decreases the capturing efficacy of the Greenfield filter in the horizontal position in vitro. In patients with unilateral common iliac vein occlusion, use of inferior vena cava filters with higher capturing efficacy may be considered.
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Affiliation(s)
- T G Vrachliotis
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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Linsenmaier U, Rieger J, Schenk F, Rock C, Mangel E, Pfeifer KJ. Indications, management, and complications of temporary inferior vena cava filters. Cardiovasc Intervent Radiol 1998; 21:464-9. [PMID: 9853163 DOI: 10.1007/s002709900305] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters. METHODS Fifty temporary IVC filters (Günther, Günther Tulip, Anthéor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis. RESULTS Filters were removed 1-12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis. CONCLUSION Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.
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Affiliation(s)
- U Linsenmaier
- Department of Radiology, Klinikum Innenstadt, Ludwig-Maximilians-Universität München, Germany
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Jaeger HJ, Kolb S, Mair T, Geller M, Christmann A, Kinne RK, Mathias KD. In vitro model for the evaluation of inferior vena cava filters: effect of experimental parameters on thrombus-capturing efficacy of the Vena Tech-LGM filter. J Vasc Interv Radiol 1998; 9:295-304. [PMID: 9540914 DOI: 10.1016/s1051-0443(98)70272-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To determine the experimental parameters in an in vitro model that influence the thrombus-capturing efficacy of the Vena Tech-LGM filter. MATERIALS AND METHODS The Vena Tech-LGM filter was evaluated in an in vitro model of the vena cava with a computer-controlled flow system with a total of 5,200 thrombi. The influences of the following experimental parameters on the capture rate were analyzed with a multiple logistic regression model: type of testing (single, double, and multiple shot testing), thrombus diameter and length, IVC diameter and orientation, flow quality and quantity, flow velocity, and the length of the prepositioned thrombus. RESULTS A significant influence on the capture rate could be demonstrated for the type of testing, the thrombus diameter and length, the IVC diameter, and with double shot testing for the length of the prepositioned thrombus and the IVC orientation. The flow quality and the peak velocity were not significant. Based on these results, a protocol for in vitro testing of IVC filters was designed. CONCLUSIONS Experimental parameters influence the thrombus-capturing efficacy of the Vena Tech-LGM filter and should be taken into account when in vitro testing is performed.
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Affiliation(s)
- H J Jaeger
- Department of Diagnostic Radiology, Städtische Kliniken Dortmund, Germany
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