Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, 310022, Zhejiang, China.
School of Artificial Intelligence, Beijing Institute of Economics and Management, Beijing, 100102, China.
Sci Rep. 2024 Aug 2;14(1):17903. doi: 10.1038/s41598-024-68925-3.
Inferior vena cava filter (IVCF) implantation is a common method of thrombus capture. By implanting a filter in the inferior vena cava (IVC), microemboli can be effectively blocked from entering the pulmonary circulation, thereby avoiding acute pulmonary embolism (PE). Inspired by the helical flow effect in the human arterial system, we propose a helical retrievable IVCF, which, due to the presence of a helical structure inducing a helical flow pattern of blood in the region near the IVCF, can effectively avoid the deposition of microemboli in the vicinity of the IVCF while promoting the cleavage of the captured thrombus clot. It also reduces the risk of IVCF dislodging and slipping in the vessel because its shape expands in the radial direction, allowing its distal end to fit closely to the IVC wall, and because its contact structure with the inner IVC wall is curved, increasing the contact area and reducing the risk of the vessel wall being punctured by the IVCF support structure. We used ANSYS 2023 software to conduct unidirectional fluid-structure coupling simulation of four different forms of IVCF, combined with microthrombus capture experiments in vitro, to explore the impact of these four forms of IVCF on blood flow patterns and to evaluate the risk of IVCF perforation and IVCF dislocation. It can be seen from the numerical simulation results that the helical structure does have the function of inducing blood flow to undergo helical flow dynamics, and the increase in wall shear stress (WSS) brought about by this function can improve the situation of thrombosis accumulation to a certain extent. Meanwhile, the placement of IVCF will change the flow state of blood flow and lead to the deformation of blood vessels. In in vitro experiments, we found that the density of the helical support rod is a key factor affecting the thrombus trapping efficiency, and in addition, the contact area between the IVCF and the vessel wall has a major influence on the risk of IVCF displacement.
下腔静脉滤器(IVCF)植入是一种常见的血栓捕获方法。通过在下腔静脉(IVC)中植入滤器,可以有效地阻止微栓子进入肺循环,从而避免急性肺栓塞(PE)。受人体动脉系统中螺旋流效应的启发,我们提出了一种螺旋可回收 IVCF,由于其螺旋结构在 IVCF 附近区域诱导血液产生螺旋流动模式,因此可以有效地避免微栓子在 IVCF 附近沉积,同时促进捕获的血栓的裂解。它还降低了 IVCF 在血管中移位和滑动的风险,因为其形状在径向方向上扩张,使其远端紧密贴合 IVC 壁,并且由于其与 IVC 内壁的接触结构是弯曲的,增加了接触面积并降低了 IVCF 支撑结构刺穿血管壁的风险。我们使用 ANSYS 2023 软件对四种不同形式的 IVCF 进行单向流固耦合模拟,结合体外微血栓捕获实验,探讨了这四种形式的 IVCF 对血流模式的影响,并评估了 IVCF 穿孔和 IVCF 移位的风险。从数值模拟结果可以看出,螺旋结构确实具有诱导血流发生螺旋流动动力学的功能,而这种功能带来的壁面剪切应力(WSS)的增加可以在一定程度上改善血栓堆积的情况。同时,IVCF 的放置会改变血流的流动状态,导致血管变形。在体外实验中,我们发现螺旋支撑杆的密度是影响血栓捕获效率的关键因素,此外,IVCF 与血管壁的接触面积对 IVCF 移位的风险有重大影响。