Department of Trauma and Orthopaedics, St Mary's Hospital, London, United Kingdom.
Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, United Kingdom.
J Vasc Surg Venous Lymphat Disord. 2021 Mar;9(2):510-524.e4. doi: 10.1016/j.jvsv.2020.11.009. Epub 2020 Nov 21.
Absorbable inferior vena cava filters (IVCFs) could be more effective and safer than standard IVCFs in theory, as they will self-resorb over time, thus rendering the need for filter retrieval and the risks associated with it unnecessary. This scoping review aims to evaluate the design of current absorbable IVCFs, review the development phase of the absorbable IVCFs, assess the efficacy of the absorbable IVCFs and their complications, and discuss the limitations and areas for future research.
MEDLINE, PubMed, and Embase databases were electronically searched and citations of relevant studies manually searched. Study selection and data extraction were performed by two independent reviewers using predetermined criteria and stored on premade proforma, respectively. The risk of bias (RoB) for both in vitro and in vivo studies were performed using established RoB tools.
Eight studies were suitable for inclusion in this scoping review; five were in vivo and three were in vitro studies. No clinical trials were found. The RoB varied from moderate to high for in vivo studies and from low to moderate for in vitro studies. Overall, there was evidence from both in vivo and in vitro studies that absorbable IVCFs were effective in clot capturing and self-resorption and could decrease complications associated with standard IVCFs. However, there was a broad lack of statistical analyses and control groups to determine the significance of these findings.
Absorbable IVCFs have shown promising features and results in preclinical models. However, significant research needs to be further performed to achieve the ideal characteristics of an absorbable IVCF before the first human trial can be conducted safely.
理论上,可吸收型下腔静脉滤器(IVCF)比标准型 IVCF 更有效且更安全,因为它们会随着时间的推移自行吸收,从而无需取回滤器及相关风险。本范围性综述旨在评估当前可吸收型 IVCF 的设计,回顾可吸收型 IVCF 的开发阶段,评估可吸收型 IVCF 的疗效及其并发症,并讨论其局限性和未来研究的领域。
通过电子检索 MEDLINE、PubMed 和 Embase 数据库,并手动检索相关研究的参考文献。两名独立审查员使用预定标准进行研究选择和数据提取,并分别将其存储在预制的表格中。使用既定的偏倚风险(RoB)工具对体内和体外研究进行 RoB 评估。
共有 8 项研究适合纳入本范围性综述,其中 5 项为体内研究,3 项为体外研究。未发现临床试验。体内研究的 RoB 从中度到高度不等,体外研究的 RoB 从低到中度不等。总体而言,体内和体外研究均有证据表明可吸收型 IVCF 可有效捕获血栓并自行吸收,可降低与标准型 IVCF 相关的并发症。然而,缺乏统计分析和对照组来确定这些发现的意义。
可吸收型 IVCF 在临床前模型中表现出有前景的特征和结果。然而,在进行首次人体试验之前,需要进一步进行大量研究,以实现可吸收型 IVCF 的理想特征。