Key result
Trapping large clots in IVC filters increases local wall shear stress nearly ~300% versus unfiltered veins.
Why the study?
The effects of inferior vena cava filter implantation on the risk of IVC thrombosis across different hemodynamic parameters remained to be investigated.
Does the implantation of a TrapEase IVC filter and the size of captured blood clots alter hemodynamic parameters (TAWSS, OSI, and RRT) associated with thrombosis risk in a 3D computational model of the inferior vena cava?
Does the implantation of a TrapEase IVC filter and the size of captured blood clots alter hemodynamic parameters (TAWSS, OSI, and RRT) associated with thrombosis risk in a 3D computational model of the inferior vena cava?
This computational fluid dynamics study demonstrates that while an unoccluded IVC filter or one with a small clot has minimal hemodynamic impact, trapping larger clots (50% to 70% of filter diameter) substantially increases downstream oscillating shear index and relative residence time, creating a prothrombotic environment.
Answers are grounded in this paper and cite their sources.
Large trapped clots may heighten downstream thrombosis risk in IVC filters; leaves open need for in vivo confirmation before clinical impact.
In this computational fluid dynamics (CFD)-based study, the effects of inferior vena cava (IVC) filter implantation on the risk of IVC thrombosis have been investigated using different hemodynamic parameters, including time-averaged wall shear stress (TAWSS), the oscillating shear index (OSI), and the relative residence time (RRT). The boundary conditions in this study have been based on physiological pulses. Additionally, the k–ω model and the Carreau model have been chosen to represent the turbulent flow regime and non-Newtonian blood, respectively. For this purpose, three blood clots with the largest cross-sectional diameters of 30%, 50%, and 70% of the filter diameter have been used. Capturing a small clot in the filter has the minimum effect on the hemodynamic parameters, while by increasing the size of the captured clot, OSI and RRT parameters increase in areas downstream of the filter on the wall. The presence of a filter and clot increases the risk of thrombosis. In the case of capturing large clots, there is the possibility of damage to endothelial cells or platelet activation. Captured clots lead to the formation of plaque and thrombus on the IVC wall. However, the possibility of thrombus growth on its surface is not negligible, particularly if larger clots are trapped in the filter.
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Moradicheghamahi et al. (2023) studied Inferior vena cava thrombosis. TrapEase inferior vena cava filter implantation with captured blood clots (30%, 50%, and 70% of filter diameter) vs. Inferior vena cava without filter and with an unoccluded filter was evaluated on Hemodynamic parameters: time-averaged wall shear stress (TAWSS), oscillating shear index (OSI), and relative residence time (RRT). Trapping a large clot (70% diameter) in an IVC filter increased average TAWSS by nearly 300% at the clot location and increased downstream RRT by 15% compared to an unfiltered vein.
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