The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Cell Biochem Biophys. 2013 Mar;65(2):159-61. doi: 10.1007/s12013-012-9411-9.
The implantation of inferior vena cava (IVC) filter was a safe and effective therapy for preventing fatal pulmonary embolism. However, there are risks associated with long-term implantation of filters. Retrievable filters are designed to be removed, but may also remain permanently. Retrieval can reduce risk of long-term complications. The difficulty or impossibility of retrieval is still an issue of retrieval filter. The major causes of filters retrieval failure were intimal overgrowth and severely tilted filter with apex embedded into the caval wall. Matrix metalloproteinases (MMPs) play a key role in neointimal hyperplasia. It is documented that neointimal hyperplasia can be reduced by inhibiting MMP activity and hence smooth muscle cell migration. MMP inhibitors (MMPI) can potently inhibit the activity of MMPs. We hypothesize that a drug-eluting filter which contains MMPI may inhibit IVC neointimal hyperplasia and decrease the adhesion between vascular wall and filter struts. After implantation of drug-eluting retrieval filter, MMPI is released slowly at the sites where the filter struts are in contact with the caval wall; the activity of MMPs of caval wall will be inhibited, injury in basement membrane is decreased, migration of SMC maybe reduced, and the release of extracellular matrix maybe lessened. Finally, neointimal hyperplasia maybe inhibited, the adhesion between vascular wall and filter maybe weakened, the success rate maybe increased, and the vascular injury during retrieval maybe reduced. The hypothesis might improve the long-term prognosis of venous thromboembolism patients.
下腔静脉（IVC）滤器的植入是预防致命性肺栓塞的一种安全有效的治疗方法。然而，长期植入滤器存在风险。可回收滤器旨在被取出，但也可能永久保留。取出可以降低长期并发症的风险。取出的难度或不可能仍然是一个取出滤器的问题。滤器取出失败的主要原因是内膜过度生长和严重倾斜的滤器，尖端嵌入腔静脉壁。基质金属蛋白酶（MMPs）在新生内膜增生中起关键作用。有文献记载，通过抑制 MMP 活性和抑制平滑肌细胞迁移，可以减少新生内膜增生。基质金属蛋白酶抑制剂（MMPI）可以有效地抑制 MMP 的活性。我们假设一种含有 MMPI 的药物洗脱滤器可能会抑制 IVC 新生内膜增生，并减少血管壁和滤器支柱之间的粘连。在植入药物洗脱可回收滤器后，MMPI 会在滤器支柱与腔静脉壁接触的部位缓慢释放；腔静脉壁 MMPs 的活性将被抑制，基膜损伤减少，SMC 迁移减少，细胞外基质的释放减少。最终，新生内膜增生可能会受到抑制，血管壁和滤器之间的粘连可能会减弱，取出的成功率可能会提高，取出过程中的血管损伤可能会减少。该假说可能会改善静脉血栓栓塞症患者的长期预后。
