Mechanisms of Günther Tulip filter tilting during transfemoral placement

Y. Matsui, M. Horikawa, K. Ohta, Y. Jahangiri Noudeh, J. A. Kaufman, K. Farsad

Research output: Contribution to journalArticle

Abstract

Objective The purpose of this study was to characterize the mechanisms of Günther Tulip filter (GTF) tilting during transfemoral placement in an experimental model with further validation in a clinical series. Materials and methods In an experimental study, 120 GTF placements in an inferior vena cava (IVC) model were performed using 6 configurations of pre-deployment filter position. The angle between the pre-deployment filter axis and IVC axis, and the proximity of the constrained filter legs to IVC wall prior to deployment were evaluated. The association of those pre-deployment factors with post-deployment filter tilting was analyzed. The association noted in the experimental study was then evaluated in a retrospective clinical series of 21 patients. Results In the experimental study, there was a significant association between the pre-deployment angle and post-deployment filter tilting (P < 0.0001). With a low pre-deployment angle (≤ 5°), a significant association was noted between filter tilting and the proximity of the constrained filter legs to the far IVC wall (P = 0.001). In a retrospective clinical study, a significant association between the pre-deployment angle and post-deployment filter tilting was also noted with a linear regression model (P = 0.026). Conclusion Significant association of the pre-deployment angle with post-deployment GTF tilting was shown in both the experimental and clinical studies. The experimental study also showed that proximity of filter legs is relevant when pre-deployment angle is small. Addressing these factors may result in a lower incidence of filter tilting.

LanguageEnglish (US)
Pages543-549
Number of pages7
JournalDiagnostic and interventional imaging
Volume98
Issue number7-8
DOIs
StatePublished - Jul 1 2017

Fingerprint

Tulipa
Inferior Vena Cava
Leg
Linear Models
Vena Cava Filters
Theoretical Models
Retrospective Studies
Incidence
Clinical Studies

Keywords

  • Experimental studies
  • Inferior vena cava
  • Inferior vena cava filter
  • Interventional imaging

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Medicine(all)
  • Radiology Nuclear Medicine and imaging

Cite this

Mechanisms of Günther Tulip filter tilting during transfemoral placement. / Matsui, Y.; Horikawa, M.; Ohta, K.; Jahangiri Noudeh, Y.; Kaufman, J. A.; Farsad, K.

In: Diagnostic and interventional imaging, Vol. 98, No. 7-8, 01.07.2017, p. 543-549.

Research output: Contribution to journalArticle

Matsui, Y. ; Horikawa, M. ; Ohta, K. ; Jahangiri Noudeh, Y. ; Kaufman, J. A. ; Farsad, K./ Mechanisms of Günther Tulip filter tilting during transfemoral placement. In: Diagnostic and interventional imaging. 2017 ; Vol. 98, No. 7-8. pp. 543-549
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abstract = "Objective The purpose of this study was to characterize the mechanisms of G{\"u}nther Tulip filter (GTF) tilting during transfemoral placement in an experimental model with further validation in a clinical series. Materials and methods In an experimental study, 120 GTF placements in an inferior vena cava (IVC) model were performed using 6 configurations of pre-deployment filter position. The angle between the pre-deployment filter axis and IVC axis, and the proximity of the constrained filter legs to IVC wall prior to deployment were evaluated. The association of those pre-deployment factors with post-deployment filter tilting was analyzed. The association noted in the experimental study was then evaluated in a retrospective clinical series of 21 patients. Results In the experimental study, there was a significant association between the pre-deployment angle and post-deployment filter tilting (P < 0.0001). With a low pre-deployment angle (≤ 5°), a significant association was noted between filter tilting and the proximity of the constrained filter legs to the far IVC wall (P = 0.001). In a retrospective clinical study, a significant association between the pre-deployment angle and post-deployment filter tilting was also noted with a linear regression model (P = 0.026). Conclusion Significant association of the pre-deployment angle with post-deployment GTF tilting was shown in both the experimental and clinical studies. The experimental study also showed that proximity of filter legs is relevant when pre-deployment angle is small. Addressing these factors may result in a lower incidence of filter tilting.",
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N2 - Objective The purpose of this study was to characterize the mechanisms of Günther Tulip filter (GTF) tilting during transfemoral placement in an experimental model with further validation in a clinical series. Materials and methods In an experimental study, 120 GTF placements in an inferior vena cava (IVC) model were performed using 6 configurations of pre-deployment filter position. The angle between the pre-deployment filter axis and IVC axis, and the proximity of the constrained filter legs to IVC wall prior to deployment were evaluated. The association of those pre-deployment factors with post-deployment filter tilting was analyzed. The association noted in the experimental study was then evaluated in a retrospective clinical series of 21 patients. Results In the experimental study, there was a significant association between the pre-deployment angle and post-deployment filter tilting (P < 0.0001). With a low pre-deployment angle (≤ 5°), a significant association was noted between filter tilting and the proximity of the constrained filter legs to the far IVC wall (P = 0.001). In a retrospective clinical study, a significant association between the pre-deployment angle and post-deployment filter tilting was also noted with a linear regression model (P = 0.026). Conclusion Significant association of the pre-deployment angle with post-deployment GTF tilting was shown in both the experimental and clinical studies. The experimental study also showed that proximity of filter legs is relevant when pre-deployment angle is small. Addressing these factors may result in a lower incidence of filter tilting.

AB - Objective The purpose of this study was to characterize the mechanisms of Günther Tulip filter (GTF) tilting during transfemoral placement in an experimental model with further validation in a clinical series. Materials and methods In an experimental study, 120 GTF placements in an inferior vena cava (IVC) model were performed using 6 configurations of pre-deployment filter position. The angle between the pre-deployment filter axis and IVC axis, and the proximity of the constrained filter legs to IVC wall prior to deployment were evaluated. The association of those pre-deployment factors with post-deployment filter tilting was analyzed. The association noted in the experimental study was then evaluated in a retrospective clinical series of 21 patients. Results In the experimental study, there was a significant association between the pre-deployment angle and post-deployment filter tilting (P < 0.0001). With a low pre-deployment angle (≤ 5°), a significant association was noted between filter tilting and the proximity of the constrained filter legs to the far IVC wall (P = 0.001). In a retrospective clinical study, a significant association between the pre-deployment angle and post-deployment filter tilting was also noted with a linear regression model (P = 0.026). Conclusion Significant association of the pre-deployment angle with post-deployment GTF tilting was shown in both the experimental and clinical studies. The experimental study also showed that proximity of filter legs is relevant when pre-deployment angle is small. Addressing these factors may result in a lower incidence of filter tilting.

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