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He J, Wang Z, Zhou YX, Ni H, Sun X, Xue J, Chen S, Wang S, Niu M. The application of inferior vena cava filters in orthopaedics and current research advances. Front Bioeng Biotechnol 2022; 10:1045220. [PMID: 36479430 PMCID: PMC9719953 DOI: 10.3389/fbioe.2022.1045220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2023] Open
Abstract
Deep vein thrombosis is a common clinical peripheral vascular disease that occurs frequently in orthopaedic patients and may lead to pulmonary embolism (PE) if the thrombus is dislodged. pulmonary embolism can be prevented by placing an inferior vena cava filter (IVCF) to intercept the dislodged thrombus. Thus, IVCFs play an important role in orthopaedics. However, the occurrence of complications after inferior vena cava filter placement, particularly recurrent thromboembolism, makes it necessary to carefully assess the risk-benefit of filter placement. There is no accepted statement as to whether IVCF should be placed in orthopaedic patients. Based on the problems currently displayed in the use of IVCFs, an ideal IVCF is proposed that does not affect the vessel wall and haemodynamics and intercepts thrombi well. The biodegradable filters that currently exist come close to the description of an ideal filter that can reduce the occurrence of various complications. Currently available biodegradable IVCFs consist of various organic polymeric materials. Biodegradable metals have shown good performance in making biodegradable IVCFs. However, among the available experimental studies on degradable filters, there are no experimental studies on filters made of degradable metals. This article reviews the use of IVCFs in orthopaedics, the current status of filters and the progress of research into biodegradable vena cava filters and suggests possible future developments based on the published literature by an electronic search of PubMed and Medline databases for articles related to IVCFs searchable by October 2022 and a manual search for citations to relevant studies.
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Affiliation(s)
| | | | | | - Hongbo Ni
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - XiaoHanu Sun
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jian Xue
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shanshan Chen
- Institute of Metal Research, Chinese Academy of Sciences (CAS), Shenyang, Liaoning, China
| | - Shuai Wang
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Meng Niu
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
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Outcomes of the TrapEase inferior vena cava filter over 10 years at a single health care system. J Vasc Surg Venous Lymphat Disord 2018; 6:599-605. [DOI: 10.1016/j.jvsv.2018.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 03/02/2018] [Indexed: 11/20/2022]
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Deso SE, Idakoji IA, Kuo WT. Evidence-Based Evaluation of Inferior Vena Cava Filter Complications Based on Filter Type. Semin Intervent Radiol 2016; 33:93-100. [PMID: 27247477 PMCID: PMC4862854 DOI: 10.1055/s-0036-1583208] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Many inferior vena cava (IVC) filter types, along with their specific risks and complications, are not recognized. The purpose of this study was to evaluate the various FDA-approved IVC filter types to determine device-specific risks, as a way to help identify patients who may benefit from ongoing follow-up versus prompt filter retrieval. An evidence-based electronic search (FDA Premarket Notification, MEDLINE, FDA MAUDE) was performed to identify all IVC filter types and device-specific complications from 1980 to 2014. Twenty-three IVC filter types (14 retrievable, 9 permanent) were identified. The devices were categorized as follows: conical (n = 14), conical with umbrella (n = 1), conical with cylindrical element (n = 2), biconical with cylindrical element (n = 2), helical (n = 1), spiral (n = 1), and complex (n = 1). Purely conical filters were associated with the highest reported risks of penetration (90-100%). Filters with cylindrical or umbrella elements were associated with the highest reported risk of IVC thrombosis (30-50%). Conical Bard filters were associated with the highest reported risks of fracture (40%). The various FDA-approved IVC filter types were evaluated for device-specific complications based on best current evidence. This information can be used to guide and optimize clinical management in patients with indwelling IVC filters.
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Affiliation(s)
- Steven E. Deso
- Division of Vascular and Interventional Radiology, Stanford University Medical Center, Stanford, California
| | - Ibrahim A. Idakoji
- Division of Vascular and Interventional Radiology, Stanford University Medical Center, Stanford, California
| | - William T. Kuo
- Division of Vascular and Interventional Radiology, Stanford University Medical Center, Stanford, California
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Rajasekhar A, Streiff MB. Vena cava filters for management of venous thromboembolism: A clinical review. Blood Rev 2013; 27:225-41. [DOI: 10.1016/j.blre.2013.07.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Xiao L, Huang DS, Shen J, Tong JJ. Introducer curving technique for the prevention of tilting of transfemoral Günther Tulip inferior vena cava filter. Korean J Radiol 2012; 13:483-91. [PMID: 22778571 PMCID: PMC3384831 DOI: 10.3348/kjr.2012.13.4.483] [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] [Received: 12/06/2011] [Accepted: 02/01/2012] [Indexed: 12/02/2022] Open
Abstract
Objective To determine whether the introducer curving technique is useful in decreasing the degree of tilting of transfemoral Tulip filters. Materials and Methods The study sample group consisted of 108 patients with deep vein thrombosis who were enrolled and planned to undergo thrombolysis, and who accepted transfemoral Tulip filter insertion procedure. The patients were randomly divided into Group C and Group T. The introducer curving technique was Adopted in Group T. The post-implantation filter tilting angle (ACF) was measured in an anteroposterior projection. The retrieval hook adhering to the vascular wall was measured via tangential cavogram during retrieval. Results The overall average ACF was 5.8 ± 4.14 degrees. In Group C, the average ACF was 7.1 ± 4.52 degrees. In Group T, the average ACF was 4.4 ± 3.20 degrees. The groups displayed a statistically significant difference (t = 3.573, p = 0.001) in ACF. Additionally, the difference of ACF between the left and right approaches turned out to be statistically significant (7.1 ± 4.59 vs. 5.1 ± 3.82, t = 2.301, p = 0.023). The proportion of severe tilt (ACF ≥ 10°) in Group T was significantly lower than that in Group C (9.3% vs. 24.1%, χ2 = 4.267, p = 0.039). Between the groups, the difference in the rate of the retrieval hook adhering to the vascular wall was also statistically significant (2.9% vs. 24.2%, χ2 = 5.030, p = 0.025). Conclusion The introducer curving technique appears to minimize the incidence and extent of transfemoral Tulip filter tilting.
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Affiliation(s)
- Liang Xiao
- Department of Radiology, The First Hospital of China Medical University, Shenyang 110001, China
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Yim NY, Chang NK, Lim JH, Kim JK. Retrograde Tempofilter II™ placement within the superior vena cava in a patient with acute upper extremity deep venous thrombosis: the filter stands on its head. Korean J Radiol 2011; 12:140-3. [PMID: 21228951 PMCID: PMC3017879 DOI: 10.3348/kjr.2011.12.1.140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 09/24/2010] [Indexed: 11/15/2022] Open
Abstract
The Tempofilter II is a widely used temporary vena cava filter. Its unique design, which includes a long tethering catheter with a subcutaneous anchor, facilitates the deployment and retrieval of the device. Despite this, the Tempofilter II has been used only in the inferior vena cava of patients with lower extremity deep venous thrombosis. In this article, we present a case of superior vena cava filtering using the Tempofilter II in patients with upper extremity deep venous thrombosis.
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Affiliation(s)
- Nam Yeol Yim
- Department of Radiology, The Armed Forces Yangju Hospital, Gyeonggi-do 482-863, Korea.
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Usoh F, Hingorani A, Ascher E, Shiferson A, Patel N, Gopal K, Marks N, Jacob T. Prospective randomized study comparing the clinical outcomes between inferior vena cava Greenfield and TrapEase filters. J Vasc Surg 2010; 52:394-9. [DOI: 10.1016/j.jvs.2010.02.280] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Revised: 02/24/2010] [Accepted: 02/24/2010] [Indexed: 11/29/2022]
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Singer MA, Henshaw WD, Wang SL. Computational Modeling of Blood Flow in the TrapEase Inferior Vena Cava Filter. J Vasc Interv Radiol 2009; 20:799-805. [DOI: 10.1016/j.jvir.2009.02.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2008] [Revised: 01/31/2009] [Accepted: 02/04/2009] [Indexed: 11/24/2022] Open
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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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Suprarenal Inferior Vena Cava Filters: A 20-Year Single-Center Experience. J Vasc Interv Radiol 2008; 19:1041-7. [DOI: 10.1016/j.jvir.2008.03.026] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Revised: 03/26/2008] [Accepted: 03/30/2008] [Indexed: 11/21/2022] Open
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Shmuter Z, Frederic FI, Gill JR. Fatal migration of vena caval filters. Forensic Sci Med Pathol 2007; 4:116-21. [DOI: 10.1007/s12024-007-9001-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2007] [Indexed: 10/22/2022]
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Harlal A, Ojha M, Johnston KW. Vena Cava Filter Performance Based on Hemodynamics and Reported Thrombosis and Pulmonary Embolism Patterns. J Vasc Interv Radiol 2007; 18:103-15. [PMID: 17296710 DOI: 10.1016/j.jvir.2006.10.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Three inferior vena cava (IVC) filters of different designs were studied to identify the potential links between published clinical results for thrombosis and recurrent pulmonary embolism (PE) rates and in vitro hemodynamics patterns in the region of the filters. MATERIALS AND METHODS The filters studied were the Greenfield over-the-wire filter (Medi-tech/Boston Scientific, Watertown, Mass), TrapEase filter (Cordis Europa, Roden, the Netherlands), and Mobin-Uddin umbrella filter (Edwards Laboratories, Santa Ana, Calif). To assess hemodynamics, velocity contour maps were generated for each filter by using the in vitro photochromic flow visualization technique. Results were obtained for both the unoccluded and partially occluded states. Steady flow (R(e) = 600) was used to model physiologic conditions. To estimate the rates of IVC occlusion and recurrent PE, the authors analyzed published clinical studies spanning more than 30 years and a U.S. Food and Drug Administration database. RESULTS For both the unoccluded and partially occluded Mobin-Uddin and TrapEase filters, regions of flow stagnation and/or recirculation and turbulence developed downstream of the filter. The Greenfield filter did not produce any prothrombotic flow patterns for either the unoccluded or partially occluded states. Results of published clinical studies supported the hemodynamic findings, with the TrapEase and Mobin-Uddin filters having high rates of IVC occlusion and recurrent PE compared with those of the Greenfield filter. CONCLUSIONS Flow stagnation or recirculation and turbulence have been linked to thrombosis and thrombus and/or PE formation. Thus, the hemodynamic results from this study may help explain the relatively higher rates of filter thrombosis and PE for the Mobin-Uddin and TrapEase filters versus the Greenfield filter.
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Affiliation(s)
- Aneal Harlal
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada
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Wax BN, Katz DS, Badler RL, Khalili M, Math KR, Mazzie JP, Weston SR, Javors BR. Complications of Abdominal and Pelvic Procedures: Computed Tomographic Diagnosis. Curr Probl Diagn Radiol 2006; 35:171-87. [PMID: 16949474 DOI: 10.1067/j.cpradiol.2006.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The postprocedural period is a critical time in which serious complications can manifest. Localization of suspected complications following abdominal and pelvic procedures can be difficult on clinical evaluation alone. For example, abdominal pain after a colonoscopy may vary in etiology and can result from simple colonic spasm to colonic perforation, hemoperitoneum, or even splenic rupture. Vague abdominal pain following a renal biopsy may be due to minimal postprocedural bleeding into and around the kidney or may be due to potentially life-threatening hemorrhage. In such patients, computed tomography can play a crucial role in the rapid identification of complications as well guidance of subsequent patient management. The purpose of this article is to demonstrate the benefit of computed tomography-assisted diagnosis of complications associated with routine procedures performed on or throughout the abdomen and pelvis, including cardiac catheterization, colonoscopy, endoscopy, percutaneous biopsy, and interventional radiology procedures.
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Affiliation(s)
- Bobbi N Wax
- Department of Radiology, Winthrop-University Hospital, Mineola, NY 11501, USA
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Ho KJ, Owens CD, Ledbetter SM, Chew DK, Belkin M. Renal venous diversion: An unusual treatment for renal vein thrombosis. J Vasc Surg 2006; 43:1283-6. [PMID: 16765255 DOI: 10.1016/j.jvs.2006.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2005] [Accepted: 01/27/2006] [Indexed: 10/24/2022]
Abstract
Renal venous thrombosis most commonly occurs in the setting of nephrotic syndrome, hypercoagulability, or dehydration. This can usually be treated with systemic anticoagulation, and the diversion is via natural draining tributaries, eg, adrenal, lumbar, or gonadal veins. Occasionally, renal venous thrombosis results from extension of a thrombotic process, such as a large renal cell carcinoma with tumor thrombus extension into the infrahepatic inferior vena cava resulting in thrombosis of the inferior vena cava and contralateral renal vein. Herein, we report a case of left renal vein thrombosis relieved by diversion through the inferior mesenteric vein.
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Affiliation(s)
- Karen J Ho
- Department of General Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. 02115, USA
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Kalva SP, Wicky S, Waltman AC, Athanasoulis CA. TrapEase Vena Cava Filter:Experience in 751 Patients. J Endovasc Ther 2006; 13:365-72. [PMID: 16784325 DOI: 10.1583/05-1741.1] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the clinical safety and efficacy of the TrapEase vena cava filter in a 4-year single-center experience. METHODS The clinical and imaging data of 751 patients (384 men; mean age 64 years, range 16-99) who had a TrapEase inferior vena cava (IVC) filter placed between January 1, 2001, and December 31, 2004, were reviewed retrospectively. More than a third of patients (297, 39.5%) presented with pulmonary embolism (PE), 188 (25.0%) had deep vein thrombosis (DVT), 40 (5.3%) had both PE and DVT, and the rest (226, 30.1%) had other symptoms. Indications for filter placement were contraindication to anticoagulation (461, 61.4%), complication of anticoagulation (42, 5.6%), failure of anticoagulation (39, 5.2%), and prophylaxis (209, 27.8%). Filters were placed in the infrarenal (n=738) or suprarenal (n=13) position through a femoral (n=729) or jugular vein (n=22) approach. Follow-up computed tomographic (CT) scans of the chest and abdomen were evaluated for recurrent PE and filter-related complications, respectively. RESULTS Three (0.4%) patients developed groin hematoma. During a mean 295-day clinical follow-up (range 1-1677), 55 (7.5%) patients developed symptoms of PE, and 1 (0.1%) death was attributed to PE. Chest CT performed for various clinical indications in 219 patients at a mean 192 days (range 1-1346) showed PE in 15 (6.8%) patients; 10 were symptomatic and 5 asymptomatic, but there were no fatalities. Follow-up abdominal CT (n=270) at a mean 189 days (range 1-1415) showed fracture of filter components in 8 (3.0%), thrombus within the filter in 68 (25.2%), thrombus extending beyond the filter in 4 (1.5%), near total caval occlusion in 2 (0.7%), and no cases of migration. CONCLUSION The TrapEase vena cava filter is effective in the prevention of pulmonary embolism, with minimal complications.
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Affiliation(s)
- Sanjeeva P Kalva
- Division of Cardiovascular Imaging & Intervention, Departments of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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