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[Determining the effectiveness of percutaneous cava filters: experimental studies]
J Neuerburg1, A Haupt-Pichler, F J Katterbach
1Klinik für Radiologische Diagnostik des Klinikums, Medizinischen Fakultät, RWTH-Aachen.
Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|April 1, 1996
Summary
The clot-trapping efficiency of 16 caval filters was evaluated. Tilting non-self-centering filters significantly reduced their effectiveness, highlighting the importance of proper filter placement.
Area of Science:
- Vascular Surgery
- Medical Device Engineering
- Biomedical Research
Background:
- Inferior Vena Cava (IVC) filters are crucial for preventing pulmonary embolism.
- Optimizing IVC filter design and deployment is essential for patient safety.
- Understanding factors affecting filter performance is key to reducing complications.
Purpose of the Study:
- To evaluate the in vitro clot-trapping capacity of 16 different IVC filters.
- To assess filter performance under varying experimental conditions, including orientation and centering.
- To determine the impact of filter tilt on clot capture efficiency.
Main Methods:
- A flow model simulating in vivo conditions was used, including a latex tube, dextran solution, and pulsatile flow.
- 16 IVC filters were tested in both horizontal and vertical positions.
- Filters were challenged with 640 or 1280 clots of varying sizes, with non-self-centering filters tested in centric and tilted positions.
Main Results:
- Optimally centered filters demonstrated high efficiency, ranging from 69.4% to 97.8%.
- All optimally centered filters successfully captured the largest thrombi.
- Tilting non-self-centering filters led to a significant decrease in efficiency, with a mean reduction of 15.5% and a maximum deterioration of 43.2%.
Conclusions:
- All evaluated IVC filters exhibited high clot-trapping efficiency under optimal, centered conditions.
- Filter orientation (vertical vs. horizontal) had a minor impact on efficiency (approx. 4.8% variation).
- Tilting of IVC filters, particularly non-self-centering types, significantly compromises their clot-trapping efficacy.