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Modeling blood flow in a tilted inferior vena cava filter: does tilt adversely affect hemodynamics?
MedLine Citation:
PMID:  21211992     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: Filter tilt is often seen with conical filters and adversely affects retrievability and clot trapping efficiency. In addition, tilt may also alter flow dynamics. This study uses computational fluid dynamics to evaluate flow past an unoccluded and partially occluded Celect inferior vena cava filter (Cook, Bloomington, Indiana). In particular, the hemodynamic response to thrombus volume and filter tilt is examined, and the results are compared with flow conditions known to be thrombogenic.
MATERIALS AND METHODS: Computer models of an upright and tilted Celect filter are constructed using high-resolution digital photographs and methods of computer-aided design. The three-dimensional models are placed inside a model cava, and steady-state flow past unoccluded and partially occluded filters is computed.
RESULTS: The volume of stagnant and recirculating flow increases with thrombus volume. In addition, as filter tilt increases, the cava wall in the direction of filter tilt is subjected to low-velocity flow and gives rise to regions of low wall shear stress.
CONCLUSIONS: Flow conditions caused by the tilted Celect filter may elevate the risk of intra/perifilter thrombosis and facilitate vascular remodeling. This latter condition may increase the potential for incorporation of the hook of the filter into the vena cava wall, thereby complicating filter retrieval. These findings also suggest that further long-term clinical follow-up with conical filters should be pursued with a specific evaluation of tilt as a factor of intrafilter thrombus and thrombosis.
Authors:
Michael A Singer; Stephen L Wang
Publication Detail:
Type:  Journal Article     Date:  2011-01-06
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  22     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  229-35     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.
Affiliation:
Center for Applied Scientific Computing, Lawrence Livermore National Laboratory, Livermore, California.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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