Reekers Jim A, Hoogeveen Yvonne L, Wijnands Marcel, Bosma Gjalt, Mulder Rudy, Oliva Vincent L
Department of Radiology, Amsterdam Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
J Vasc Interv Radiol. 2004 Mar;15(3):261-7. doi: 10.1097/01.rvi.0000116186.30591.49.
A new inferior vena cava filter was evaluated in vivo to determine the percutaneous retrievability after an implantation period of up to 18 days.
The inferior venae cavae of six goats were percutaneously implanted with three filters, and one animal received two filters. To assess filter stability, a plain radiograph was obtained after 7-9 days and on the day of retrieval. After cavography, filter retrieval with an endovascular snare and retrieval catheter was performed in three animals after 12 days and in three others after 14 days. In one animal, retrieval of one filter was performed after 18 days, and one filter was intended to be permanent. Twenty-eight days after filter retrieval, cavography was performed before inferior vena cava removal for gross and histologic examination.
All filters (N = 20) were implanted without complications. There was no migration during the implantation period. Preretrieval cavography demonstrated all filters to be patent and centered. Filters intended for retrieval (n = 19) were all successfully extracted at 12 (nine filters), 14 (nine filters), and 18 days (one filter). For the animal with the filter extracted at 18 days, one filter remained in situ intentionally. Postretrieval cavography showed no visible signs of vessel wall anomalies. There were no complications during the 28 days of follow-up after retrieval. Presacrifice cavography showed no evidence of caval wall abnormalities. In all animals, gross examination of the inner wall of the explanted vena cava showed only minimal macroscopic changes. The struts of the filter in situ for 46 days (18 days with 28 days of follow-up) were overgrown with neointima. Histological study of the 19 filter retrieval sites revealed no to moderate intima proliferation, minimal residual signs of hemorrhages, and no or only occasional slight inflammatory reaction.
In this animal model, the new vena cava filter demonstrated event-free retrieval, without postretrieval complications, up to 18 days postimplantation. After implantation of 46 days, the filter showed neointima overgrowth of the struts.
对一种新型下腔静脉滤器进行体内评估,以确定在长达18天的植入期后的经皮可回收性。
对六只山羊的下腔静脉经皮植入三个滤器,一只动物植入两个滤器。为评估滤器稳定性,在7 - 9天后及回收当天拍摄平片。在进行腔静脉造影后,三只动物在12天后、另外三只动物在14天后使用血管内圈套器和回收导管进行滤器回收。在一只动物中,一个滤器在18天后进行回收,另一个滤器打算永久性留置。滤器回收28天后,在切除下腔静脉前进行腔静脉造影,以便进行大体和组织学检查。
所有滤器(共20个)植入时均无并发症。植入期间无移位。回收前的腔静脉造影显示所有滤器通畅且位置居中。打算回收的滤器(19个)在12天(9个滤器)、14天(9个滤器)和18天(1个滤器)时均成功取出。对于在18天取出滤器的动物,一个滤器有意留在原位。回收后的腔静脉造影未显示血管壁异常的明显迹象。回收后28天的随访期间无并发症。处死前的腔静脉造影未显示腔静脉壁异常的证据。在所有动物中,对取出的下腔静脉内壁进行大体检查仅显示微小的宏观变化。原位放置46天(18天植入加28天随访)的滤器支柱被新生内膜覆盖。对19个滤器回收部位的组织学研究显示,内膜增生无至中度,出血残留迹象轻微,无或仅有偶尔的轻微炎症反应。
在该动物模型中,新型下腔静脉滤器在植入后长达18天内均可顺利回收,且回收后无并发症。植入46天后,滤器显示支柱有新生内膜过度生长。