Numerical Analysis of the Hemodynamics and Embolus Capture of a Greenfield Vena Cava Filter

2005 ◽  
Vol 128 (3) ◽  
pp. 360-370 ◽  
Author(s):  
T. N. Swaminathan ◽  
Howard H. Hu ◽  
Aalpen A. Patel
Keyword(s):  
Shear Stress ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Central Hole ◽  
Stagnation Zone ◽  
Greenfield Filter ◽  
Vena Cava Filters ◽  
Different Characteristics

Background: Vena Cava filters are used to prevent pulmonary embolism in patients with deep vein thrombosis who are unresponsive to anticoagulation therapy. Various filter designs exist in the market with different characteristics distinguishing them. An understanding of the characteristics of these filters is desirable in order to develop better designs. Methods: A computational fluid dynamical study of the flow over an unoccluded stainless steel Greenfield Vena Cava filter (Boston Scientific, Watertown, MA) to determine its properties has been performed. Simulation of flow over a filter placed axisymmetrically in a rounded inferior vena cava has been performed at a Reynolds numbers of 1000 and the consequences of the flow (by studying parameters like shear stress and stagnation zones) have been discussed. Furthermore, a new finite element based numerical method has been developed that allows the study of capturing properties of Inferior Vena Cava filters. The key idea is the introduction of a thin-wire-model (TWM) that enables a drastic reduction in the computational cost while still maintaining control on the physics of the problem. This numerical technique has been applied to evaluate the embolus capture characteristic of a Greenfield filter. Results: The flow around the unoccluded filter is found to be steady and laminar at the conditions studied. A recirculation/stagnation zone develops immediately downstream of the filter head. This zone is significantly larger when the central hole is occluded. The shear stress and stagnation zone properties for such a flow over a Greenfield filter are compared with existing literature (in vitro studies). A graph showing the regions wherein clots escape or get captured has been determined by a means of numerical simulations. The data has further been analyzed to determine the probability of clot capture as function of the clot size. Conclusions: The stagnation zone formed behind the head of the Greenfield filter is found to be smaller in size when compared to that of the same filter with the central hole occluded. A map of the shear stress distribution shows a small region having the potential for thrombogenesis. The non-Newtonian properties of blood are not seen to cause much variation in the flow field when compared to the Newtonian model. However variation in the cava size leads to a significant change in the shear stresses. This study also establishes a novel method wherein computational means are used to determine the efficacy of clot capturing of filters. These techniques can further be used to compare the different characteristics among filters.

scholarly journals The use of retrievable inferior vena cava filters in pregnancy: Another successful case report, but are we actually making a difference?

2016 ◽  
Vol 9 (3) ◽  
pp. 102-105 ◽  
Author(s):  
Lodewyk E Du Plessis ◽  
Ben W Mol ◽  
John M Svigos
Keyword(s):  
Venous Thromboembolism ◽  
Mortality Rate ◽  
Inferior Vena Cava ◽  
Risk Reduction ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters

Background Pregnant women with venous thromboembolism are traditionally managed with anticoagulation, but inferior vena cava filters are an alternative. We balanced risks and benefits of an inferior vena cava filter in a decision analysis. Methods We constructed a decision model to compare in pregnant women with VTE the outcome of (1) inferior vena cava filter and anticoagulant treatment versus (2) anticoagulant treatment only. Results Assuming a 63% risk reduction from an inferior vena cava filter (baseline mortality rate of venous thromboembolism of 0.5%), 318 women would need to be treated with inferior vena cava filters to prevent one venous thromboembolism related maternal death. Sensitivity analyses indicated that at a mortality rate of 0.5% the risk reduction from inferior vena cava filters needed to be 80%, while at a mortality rate of 2% a risk reduction of 20% would justify inferior vena cava filters. Conclusions In view of their potential morbidity, inferior vena cava filters should be restricted to pregnant woman at strongly increased risk of recurrent venous thromboembolism.

Inferior Vena Cava Filter Evaluation and Management for the Diagnostic Radiologist: A Comprehensive Review Including Inferior Vena Cava Filter-Related Complications and PRESERVE Trial Filters

2019 ◽  
Vol 70 (4) ◽  
pp. 367-382 ◽  
Author(s):  
Osman Ahmed ◽  
Shermeen Sheikh ◽  
Patrick Tran ◽  
Brian Funaki ◽  
Alexandria M. Shadid ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Cross Sectional ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters ◽  
Cross Sectional Imaging

Inferior vena cava filters are commonly encountered devices on diagnostic imaging that were highlighted in a 2010 Food and Drug Administration safety advisory regarding their complications from long-term implantation. The Predicting the Safety and Effectiveness of Inferior Vena Cava Filters (PRESERVE) trial is an ongoing after-market study investigating the safety and utility of commonly utilized filters in practice today. While most of these filters are safe, prompt recognition and management of any filter-associated complication is imperative to prevent or reduce the morbidity and mortality associated with them. This review is aimed at discussing the appropriate utilization and placement of inferior vena cava filters in addition to the recognition of filter-associated complications on cross-sectional imaging. An overview of the PRESRVE trial filters is also provided to understand each filter's propensity for specific complications.

scholarly journals Design Optimization of Vena Cava Filters: An Application to Dual Filtration Devices

2010 ◽  
Vol 132 (10) ◽  
Author(s):  
Michael A. Singer ◽  
Stephen L. Wang ◽  
Darin P. Diachin
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Inferior Vena Cava ◽  
Objective Function ◽  
Design Optimization ◽  
Inferior Vena ◽  
Vena Cava ◽  
Shear Stresses ◽  
Vena Cava Filters ◽  
Wall Shear

Pulmonary embolism (PE) is a significant medical problem that results in over 300,000 fatalities per year. A common preventative treatment for PE is the insertion of a metallic filter into the inferior vena cava that traps thrombi before they reach the lungs. The goal of this work is to use methods of mathematical modeling and design optimization to determine the configuration of trapped thrombi that minimizes the hemodynamic disruption. The resulting configuration has implications for constructing an optimally designed vena cava filter. Computational fluid dynamics is coupled with a nonlinear optimization algorithm to determine the optimal configuration of a trapped model thrombus in the inferior vena cava. The location and shape of the thrombus are parametrized, and an objective function, based on wall shear stresses, determines the worthiness of a given configuration. The methods are fully automated and demonstrate the capabilities of a design optimization framework that is broadly applicable. Changes to thrombus location and shape alter the velocity contours and wall shear stress profiles significantly. For vena cava filters that trap two thrombi simultaneously, the undesirable flow dynamics past one thrombus can be mitigated by leveraging the flow past the other thrombus. Streamlining the shape of the thrombus trapped along the cava wall reduces the disruption to the flow but increases the area exposed to low wall shear stress. Computer-based design optimization is a useful tool for developing vena cava filters. Characterizing and parametrizing the design requirements and constraints is essential for constructing devices that address clinical complications. In addition, formulating a well-defined objective function that quantifies clinical risks and benefits is needed for designing devices that are clinically viable.

scholarly journals Prophylactic placement of inferior vena cava filters and the risk of death or venous thromboembolism in severe trauma patients: a retrospective study comparing two hospitals with different approaches

2021 ◽  
Vol 10 (3) ◽  
pp. 205846012199934
Author(s):  
Thien Trung Tran ◽  
Haraldur Bjarnason ◽  
Jennifer McDonald ◽  
Nils Oddvar Skaga ◽  
Damon E Houghton ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Filter Placement ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters

Background Prophylactic use of inferior vena cava filters to prevent pulmonary embolism in trauma is controversial. The practice varies between hospitals and countries, in part due to conflicting evidence and guidelines. Purpose To compare the effects of pulmonary embolism, deep venous thrombosis and mortality in two hospitals using prophylactic inferior vena cava filter placement or prophylactic anticoagulation alone. Material and Methods Patients presenting with severe trauma were recruited from two level-1 trauma centres between January 2008 and December 2013. Recruited patients from an US hospital having prophylactic inferior vena cava filter inserted were compared to a Scandinavian hospital using prophylactic anticoagulation alone. Inclusion criteria were age >15 years, Injury Severity Score >15 and survival >24 h after hospital admission. Patients with venous thromboembolism diagnosed prior to inferior vena cava filter placement were excluded. A Cox proportional hazard regression model was used with adjustment for immortal time bias and predictor variables. Results In total, 951 patients were reviewed, 282 from an US hospital having inferior vena cava filters placed and 669 from a Scandinavian hospital without inferior vena cava filters. The mean age was 45.9 vs. 47.4 years and the mean Injury Severity Score was 29.8 vs. 25.9, respectively. Inferior vena cava filter placement was not associated with the hazard of pulmonary embolism (Hazard ratio=0.43; 95% confidence interval (CI) 0.12, 1.45; P=0.17) or mortality (Hazard ratio=1.16; 95% CI 0.70, 1.95; P=0.56). However, an increased rate of deep venous thrombosis was observed with inferior vena cava filters in place (Hazard ratio=3.75; 95% CI 1.68, 8.36; P=0.001). Conclusion In severely injured trauma patients, prophylactic inferior vena cava filter placement was not associated with pulmonary embolism or mortality. However, inferior vena cava filters were associated with increased rate of deep venous thrombosis.

Temporäre Vena-Cava-Filter verhindern nicht immer eine tödliche Pulmonalembolie

VASA ◽  
2000 ◽  
Vol 29 (4) ◽  
pp. 292-294 ◽  
Author(s):  
Robert Bucek ◽  
Maca ◽  
Ahmadi ◽  
Minar
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Fatal Pulmonary Embolism ◽  
Vein Thrombosis ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters ◽  
Deep Vein

We describe the case of a young woman who developed fatal pulmonary embolism during thrombolytic therapy of a deep pelvic and leg vein thrombosis, despite the insertion of a temporary vena cava filter. So the opinion that the insertion of inferior vena cava filters always prevents lethal pulmonary embolism caused by thrombi of the deep vein system must be revised.

Transvenous Interruption of the Inferior Vena Cava. New Model of Vena Cava Filter. Preliminary Results in 143 Cases

1988 ◽  
Vol 3 (4) ◽  
pp. 217-226 ◽  
Author(s):  
L. Castellani ◽  
J. Pietri ◽  
H. Nicaise ◽  
L. Quilliet ◽  
P. Lermusiaux ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Greenfield Filter ◽  
New Model ◽  
New Device ◽  
Preliminary Results

A new device for transvenous interruption of the inferior vena cava is described. Based upon the Greenfield filter, upward- and downward-facing hooks prevent movement of the filter within the vein. Results of the use of the device in 143 patients after 3 months are presented and compared to other filters.

scholarly journals Inferior vena cava filters: a review

2021 ◽  
Vol 9 (8) ◽  
pp. 2496
Author(s):  
José Ángel Barajas-Colón ◽  
Baltazar Barrera-Mera ◽  
Rodrigo Banegas-Ruiz ◽  
José Juan Vargas-Morales ◽  
Elvira Barrera-Calva ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Vein Thrombosis ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters ◽  
Deep Vein

Venous thromboembolism is an entity that ranges from deep vein thrombosis to pulmonary embolism, both are highly prevalent diseases in our environment and potentially fatal. The intention of this review is to compile information regarding the indications, contraindications, complications and comparison of different therapeutic methods in order to create an algorithm. An exhaustive review was performed with the available literature, using the PubMed, ScienceDirect, Scopus and Cochrane databases from 2004 to 2021. The search criteria were formulated to identify reports related to inferior vena cava filters. Venous thrombosis manifested as deep vein thrombosis or pulmonary embolism is a highly prevalent disease in our setting with high morbidity and mortality. Currently, different therapeutic options have been presented to address this pathology, in this review we focus on the developments regarding the use of vena cava filters. Reviewing the indications for the placement of a vena cava filter, we find absolute indications such as a contraindication to anticoagulation and high risk of massive pulmonary embolism. Pulmonary thromboembolism is a disease with high prevalence and mortality, we have highly effective and novel treatments such as the vena cava filter, patients should be selected carefully always taking into account the absolute and relative indications.

scholarly journals Fractured Inferior Vena Cava Filter Strut Presenting with ST-Segment Elevation and Cardiac Tamponade

2015 ◽  
Vol 42 (2) ◽  
pp. 181-183 ◽  
Author(s):  
Dheeraj Khurana ◽  
Jaffar Raza ◽  
Sunil Abrol ◽  
Neil L. Coplan
Keyword(s):  
Inferior Vena Cava ◽  
Right Ventricle ◽  
Cardiac Tamponade ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
St Segment Elevation ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters

The fracture of an inferior vena cava filter strut and its migration to the heart is a rare sequela of implanted inferior vena cava filters. Perforation through the right ventricle into the pericardium with resultant cardiopulmonary compromise is even less frequent. We report the case of a 53-year-old man who presented with chest pain and hypotension consequent to cardiac tamponade. A fractured inferior vena cava filter strut had migrated and perforated his right ventricle. The fractured strut was successfully removed by means of cardiac surgery. Inferior vena cava filters should be placed when necessary to minimize the risk of pulmonary embolism, and regular radiologic monitoring should be performed; however, the eventual extraction of retrievable filters should be considered. In addition to discussing the patient's case, we briefly review the relevant medical literature.

Sign in / Sign up

Export Citation Format

Share Document