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Celect Inferior Vena Cava Wall Strut Perforation Begets Additional Strut Perforation
Joshua D Dowell1, Jordan C Castle2, Maureen Schickel3
1Division of Interventional Radiology and Department of Radiology, Wexner Medical Center, The Ohio State University,395 W. 12th Ave., Suite 424, Columbus, OH 43210; Department of Biomedical Engineering, Wexner Medical Center, The Ohio State University, 395 W. 12th Ave., Suite 424, Columbus, OH 43210.
Journal of Vascular and Interventional Radiology : JVIR
|August 3, 2015
Summary
Inferior vena cava (IVC) filter strut perforation progresses over time, particularly in women and those with malignancy. Finite element modeling can predict this worsening perforation, suggesting closer patient follow-up.
Area of Science:
- Vascular surgery
- Biomedical engineering
- Radiology
Background:
- Inferior vena cava filters (IVCFs) are used to prevent pulmonary embolism.
- Complications such as strut perforation can occur following IVCF placement.
- Understanding risk factors and mechanical behavior is crucial for patient safety.
Purpose of the Study:
- To identify risk factors for Celect IVCF strut perforation.
- To utilize finite element modeling to predict the mechanical impact of long-dwelling filters.
- To assess the progression of IVCF strut perforation over time.
Main Methods:
- Retrospective review of 91 patients with three CT scans post-Celect IVCF placement.
- Development of 3D finite element models to simulate IVCF mechanical deformation in vivo.
- Measurement of strut forces on the IVC wall based on luminal area and tilt angle.
Main Results:
- Progressive strut perforation was observed in 66% of patients over time (final CT: 79%).
- Higher perforation rates were associated with female patients and those with a history of malignancy.
- Finite element modeling showed increased strut force with decreased IVC diameter, supporting a progressive perforation mechanism.
Conclusions:
- Celect IVCF strut perforation is progressive and more prevalent in female patients and those with malignancy.
- 3D finite element modeling can predict progressive perforation.
- Closer follow-up for at-risk patients may help prevent or mitigate filter complications.
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