Publish Time: 2022-09-20 Origin: Site
KOSSEL’s vena cava filter adopts advanced filtration technology, which helps to prevent movement, inclination and penetration. The following is an introduction to it.
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Applicability of vena cava filter
How to choose vena cava filter
Generally speaking, it is known that pulmonary embolism and deep vein thrombosis are the indications for placing vena cava filters. Venous thrombosis is easy to involve femoral, popliteal vein, iliac vein or inferior vena cava. 25-77% of these patients can't be treated with anticoagulation, mainly because anticoagulation can lead to serious complications such as bleeding for some coexisting diseases. For example, digestive tract ulcer, positive occult blood test, recent history of surgery (especially eye, brain and spinal cord surgery), hemophilia and so on.
If pulmonary embolism has occurred, the vena cava filter should be placed with or without anticoagulant therapy. Indications for placement of preventive vena cava filter are:
1) Before the operation of deep vein thrombosis (25% have pulmonary embolism);
2) unstable thrombosis in the inferior vena cava;
3) Chronic pulmonary hypertension;
4) Critical cardiopulmonary function reserve.
The incidence of complications of anticoagulation in patients with metastatic tumor or pulmonary embolism of lower limbs is very high, and Moore reported that 25% of them had bleeding or death.
Even with adequate anticoagulation, 19% of patients will suffer from recurrent pulmonary embolism. Cohen et al. reported 41 such cases. No bleeding complication occurred after preventive placement of vena cava filter, and only one case (2.4%) suffered from fatal pulmonary embolism.
Animal experiments show that the bacterial embolus filtered by filter can be killed by systemic antibacterial treatment, and its mortality and complications are significantly lower than those of simple inferior vena cava ligation. Bacterial venous inflammation can easily lead to pulmonary infarction, and it is also an indication for vena cava filter placement.
A good filter should have the following characteristics:
1) the integrated projection area of the filter is small (low resistance to blood flow);
2) easy release;
3) Good biocompatibility;
4) Good elasticity and corrosion resistance;
5) No coagulation promoting effect;
6) Non-ferromagnetic;
7) Recyclable (taken out of the body by minimally invasive method after a period of time);
8) Keep the vena cava completely open;
9) No pulmonary embolism occurred after placement;
10) The inferior vena cava will not be damaged and will not be displaced.
Recyclable filters are available in the market, but they can be officially used without FDA approval. The "recyclable" feature can only be realized within a short time after the junction between the filter and the vein wall is completely epithelized. In practice, it needs to be placed for a longer time to help patients tide over difficulties (venous and pelvic surgery, etc.). Therefore, if the filter can be safely recovered after being kept in the vena cava for a longer time, it is a research goal.
There have been many reports on the clinical application results of inferior vena cava filters, and there seems to be no significant difference in curative effect between different types of filters. Up to now, there is no multicenter, randomized prospective study. Complications such as displacement have been encountered in the application of various filters. Fortunately, the incidence is low and clinically acceptable.
Based on the above reasons, the choice of filters depends largely on personal experience and training methods, but there are also several principles that must be observed: 1) Different filters have different placement ways, and should be operated according to the way required by the manufacturer. 2) Determine the diameter of the inferior vena cava. Except Bird's Nest IVC Filter, common filters are only suitable for vena cava with diameter less than 20mm. In 3% of patients, the inferior vena cava is larger than 20mm, but smaller than 30mm. At this time, the bird's nest or bilateral iliac veins can be used to place the filter at the same time. Although this double iliac vein filter technique has clinical significance, its obstruction rate is higher than that of the internal vena cava filter.
KOSSEL attaches importance to product quality, takes customer satisfaction as the goal, and builds a superior company. If you need a vena cava filter, please contact us.
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