Over-the-wire deployment techniques of option elite inferior vena cava filter: 3D printing vena cava phantom study

Abstract

To compare filter tilt and filter jumping during Option inferior vena cava (IVC) filter deployment with 3 different wires techniques using a 3-dimensional (3D) printing vena cava phantom. Materials and methods: An IVC 3D printed vena cava phantom was made from a healthy young male's computed tomographic data. Option IVC filters were deployed with 3 different wires: i) original push wire, ii) hydrophilic stiff wire, and iii) bent stiff wire. Right internal jugular and right femoral access were used 5 times with each wire. Filter tilt angle, tilt ratio, jumping, and tip abutment to the IVC wall were analyzed. Results: The transfemoral approach with original push wire had significantly higher tilt angle than did the transjugular approach (6.1˚± 1.9 vs. 3.5˚± 1.3, p = 0.04). Mean tilt ratio was significantly lower with the bent wire with transfemoral access (0.49 ± 0.13 vs. 0.78 ± 0.18 [original push-wire] and 0.67 ± 0.08 [stiff wire], p = 0.019). The ratio was lower also with original push wire with transjugular access (0.34 ± 0.19 vs. 0.57 ± 0.11 [stiff wire] and 0.58 ± 0.17 [bent wire], p = 0.045). Filter jumping occurred more often with the transjugular approach with original push wire than with stiff or bent-wire delivery. Filter tip abutment to the IVC wall occurred only with the transfemoral approach. Conclusions: Bent wire with transfemoral access and original push wire with transjugular access had lower filter tilt ratio at Option IVC filter deployment. However, filter jumping was common using the original push wire with transjugular access.

Over-the-Wire Inferior Vena Cava Filter Placement: How We Do It

“…In addition, the original guide wire had the lowest filter tilt ratio (0.34 vs. 0.57 and 0.58 for stiff hydrophilic wire and bent stiff wire, respectively, p ¼ 0.045) in the jugular access approach. 25 Note the filter tilt ratio was more significant in this study in comparison to the study of Kim et al, 5 which could be secondary to the elasticity of the phantom model and the lack of physiologic variables such as respiratory motion and cardiac cycles. In our practice, we believe that the OTW technique can improve the filter stability and reduce the filter tilt, particularly in a tortuous IVC.…”

Relationship between vascular access and angulation of vena cava filter at placement and retrieval: a multicenter retrospective cohort study

“…Conjunctive endovascular strategies could also be a factor for potential IVC filter tilt. 14 Park et al 15 demonstrated that implementing the original push wire technique through FVs approach led to a significantly increased incidence of IVC filter tilt. In contrast, employing a bent stiff wire via IJV access resulted in a higher prevalence of filter tilt.…”