The main treatment of venous thromboembolism (VTE) is anticoagulation. In recent years, various methods such as embolectomy, Catheterdirectedthrombolysis(CDT) and percutaneousmechanical thrombectomy (PMT) have emerged one after another, but they cannot be separated from the protection of inferior vena cava filter (IVCF).

IVCF(the inferior vena cava filter) is a device to prevent the occurrence and recurrence of APTE. The use of IVCF as a treatment of thromboembolic disease applies fundamentally for patients of the less efficacy and contraindications to anticoagulation. According to its appearance and contact mode with the inferior vena cava wall, it is further divided into umbrella vena cava filter and spindle-shaped vena cava filter.

What are the advantages of umbrella-shaped vena cava filter over spindle-shaped vena cava filter?

1. long-term retrieval period, improve filter retrieval rate.

The FDA recommends that, given the patient's risk/benefit profile, the retrieval period for vena cava filters is 29 to 54 days after implantation.

The umbrella-shaped vena cava filter takes a long time to implant, such as the Octoparms® vena cava filter retrieval period up to 90 days;

The time of spindle-shaped vena cava filter was short, and the retrieval period was within 2 weeks. After 2 weeks, the intimal hyperplasia was obvious.

Animal experiment

The animal experiment of spindle-shaped vena cava filter showed that the intima hyperplasia was obvious at 14 days after implantation, and severe hyperplasia appeared at 21 days after implantation.

What are the risks of having a vena cava filter implanted beyond the prescribed period?

It is easy to have difficulty in retrieval, and avulsion of the new endothelium, resulting in damage or even rupture of the inferior vena cava wall.

The umbrella-shaped vena cava filter

The spindle-shaped vena cava filter

2. Small vascular injury

The point contact between the umbrella vena cava filter and the vascular wall of the inferior vena cava is low in endothelialization and small in vascular damage.

The contact area of spindle-shaped vena cava filter is large, and the blood vessel damage is relatively serious when it is retrieved.

3. More cost-effective

When the spindle-shaped vena cava filter has reached the retrieval period (12-14d), if there are still a large number of thrombus in the inferior vena cava and iliofemoral veins, the extraction time of the filter will be delayed clinically, and the "filter moving" method will be adopted to extend the time of the filter placement [1], but either way will greatly increase the cost of the patient.