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: Research - peer-reviewArticle

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
Clinical Studies
Vena Cava Filters
Theoretical Models
Retrospective Studies
Incidence

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: Research - peer-reviewArticle

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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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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