Changes in perfusion angiography after IVC filter placement and retrieval

Area of Science:

• Cardiovascular imaging
• Medical device evaluation
• Hemodynamics

Background:

• Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.
• Concerns exist regarding their impact on blood flow dynamics, potentially causing vascular remodeling and thrombosis.
• However, in vivo data evaluating these hemodynamic effects is scarce.

Purpose of the Study:

• To assess hemodynamic flow parameter differences using 2D-perfusion angiography before and after IVC filter placement or retrieval.
• To investigate the in vivo hemodynamic impact of IVC filters.

Main Methods:

• Retrospective analysis of 2D-perfusion angiography from 37 patients undergoing IVC filter placement (n=18) or retrieval (n=23).
• Calculated contrast arrival time (AT), time-to-peak (TTP), wash-in-rate (WIR), and mean transit time (MTT) in regions of interest (ROIs) superior to, inferior to, and within the filter.
• Compared hemodynamic parameters pre- and post-intervention and correlated them with filter dwell time.

Main Results:

• No significant changes in hemodynamic variables were observed after IVC filter placement.
• Following filter retrieval, ROIs within and inferior to the filter demonstrated significantly shorter TTP and MTT.
• No significant correlation was found between hemodynamic parameter changes and filter dwell time.

Conclusions:

• Two-dimensional (2D)-perfusion angiography is a feasible method for evaluating in vivo hemodynamic effects of IVC filters.
• IVC filter retrieval significantly alters hemodynamic parameters (TTP, MTT) in the vicinity of the filter.
• These observed hemodynamic changes suggest a functional delay secondary to filter presence, independent of dwell time.