Gong Maofeng, Jiang Rui, Guo Kang, He Xu, Gu Jianping
Department of Interventional and Vascular Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210006, People's Republic of China.
Imaging Department of Yixing Traditional Chinese Medicine Hospital, Yixing, Jiangsu, 214200, People's Republic of China.
J Inflamm Res. 2025 Jun 24;18:8305-8315. doi: 10.2147/JIR.S523120. eCollection 2025.
Neointimal hyperplasia (NIH) is a risk factor for inferior vena cava filter (IVCF) retrieval failures and damage to the inferior vena cava (IVC) wall post-retrieval. Unfortunately, the mechanical properties of IVCFs have not been evaluated and are not readily available from the manufacturer. This study aimed to investigate the correlations between radial support force (RSF) and NIH, and the release of tumor necrosis factor-alpha (TNF-α) during this process.
RSFs exerted by IVCF struts at various IVC diameters were analyzed with five replicates in vitro. In vivo, Bama swine were randomly fitted with IVCFs of 32 mm or 20 mm diameter. After a dwelling time of three weeks, the thickness of NIH and TNF-α content in the areas adjacent to IVCF struts were determined on hematoxylin and eosin. Correlations were assessed using Student's -test, chi-square test, and regression analyses.
A mismatch between IVC and IVCF diameter generated an oversizing ratio (OR), with a mean OR of 113.06 ± 48.91% (range, 61.73-166.52%). RSFs of 4.56 ± 0.97 N (range, 3.54-5.61 N) showed a linear dose-response relationship with ORs ( = 0.718, <0.001). NIH thickness increased with the enlarged RSFs, and regression analyses demonstrated a U-shaped dose-response relationship ( =0.630, <0.001). A larger TNF-α content at minimal caval diameter was observed with increased RSFs, indicating a more severe presence of TNF-α following the increased RSF ( =0.777, <0.001).
Differences in RSFs are consistent with ORs; RSFs increased with the larger ORs of IVCF and IVC diameter. Increased RSFs correlate with greater NIH thickness. Evaluation of IVCF yielded a significantly higher RSF at a smaller caval diameter, with higher levels of TNF-α during expansion, supporting a close association with greater NIH.
新生内膜增生（NIH）是下腔静脉滤器（IVCF）取出失败及取出后下腔静脉（IVC）壁损伤的一个危险因素。遗憾的是，IVCF的机械性能尚未得到评估，且制造商也未提供相关信息。本研究旨在探讨径向支撑力（RSF）与NIH之间的相关性，以及在此过程中肿瘤坏死因子-α（TNF-α）的释放情况。
在体外对不同IVC直径下IVCF支柱施加的RSF进行分析，共进行五次重复实验。在体内，将巴马猪随机植入直径为32mm或20mm的IVCF。经过三周的留置时间后，采用苏木精-伊红染色法测定IVCF支柱附近区域的NIH厚度和TNF-α含量。使用Student's检验、卡方检验和回归分析评估相关性。
IVC与IVCF直径不匹配产生了过大尺寸比（OR），平均OR为113.06±48.91%（范围为61.73 - 166.52%）。4.56±0.97N（范围为3.54 - 5.61N）的RSF与OR呈线性剂量反应关系（r = 0.718，P<0.001）。NIH厚度随RSF增大而增加，回归分析显示呈U形剂量反应关系（r = 0.630，P<0.001）。随着RSF增加，在最小腔静脉直径处观察到更高的TNF-α含量，表明RSF增加后TNF-α的存在更为严重（r = 0.777，P<0.001）。
RSF的差异与OR一致；RSF随着IVCF与IVC直径的更大OR而增加。RSF增加与更大的NIH厚度相关。对IVCF的评估显示，在较小的腔静脉直径处RSF显著更高，扩张过程中TNF-α水平更高，这支持了其与更大的NIH密切相关。
