CFD Study on Hemodynamic Characteristics of Inferior Vena Cava Filter Affected by Blood Vessel Diameter
Abstract
Pulmonary embolism (PE), caused by deep venous thrombosis (DVT), is a disease with high morbidity and mortality. Implantation of inferior vena cava filters is an important method for the clinical prevention of PE. The hemodynamic characteristics of filters implanted in the inferior vena cava (IVC) have a significant impact on their performance. However, IVC diameters vary among patients. This may have a direct impact on the hemodynamic properties of the filter. At present, there is no research on this kind of problem to be investigated. In this paper, the hemodynamic properties of the VenaTech convertible filter were simulated in three different IVC models of 15, 20 and 25 mm diameters, using computational fluid dynamics (CFD) as a control variable (only the IVC diameter is varied). The results showed that the diameter has a significant impact on the hemodynamic characteristics after filter implantation. The IVC diameter has a great influence on the stagnation zone of the blood flow, the maximum wall shear stress (WSS) on the upstream side along the filter wire, and the flow resistance. The case of 15 mm diameter was the most prone to thrombus formation downstream of the filter head in the IVC, but the larger WSS on the upstream along the filter wire may facilitate thrombus lysis. Therefore, the change in vessel diameter should be considered when performing filter implantation for patients.
References
2. Duffett, L., Castellucci, L. A., Forgie, M. A. (2020). Pulmonary embolism: Update on management and controversies. British Medical Journal, 370, M2177.
3. Wenger, N., Sebastian, T., Engelberger, R. P., Kucher, N., Spirk, D. (2021). Pulmonary embolism and deep vein thrombosis: Similar but different. Thrombosis Research, 206, 88–98.
4. Choi, J. H., Lee, S. Y., Park, Y. H., Park, J. H., Kim, K. H. (2020). In-hospital outcome in patients underwent extracorporeal membrane oxygenation in life-threatening high-risk pulmonary embolism. International Journal of Heart Failure, 2(3), 187–194.
5. Jamil, A., Johnston-Cox, H., Pugliese, S., Nathan, A. S., Fiorilli, P. et al. (2021). Current interventional therapies in acute pulmonary embolism. Progress in Cardiovascular Diseases, 69, 54–61.
6. Freund, Y., Cohen-Aubart, F., Bloom, B. (2022). Acute pulmonary embolism: A review. The Journal of the American Medical Association, 328(13), 1336–1345.
7. Ortel, T. L., Neumann, I., Ageno, W., Beyth, R., Clark, N. P. et al. (2020). American society of hematology 2020 guidelines for management of venous thromboembolism: Treatment of deep vein thrombosis and pulmonary embolism. Blood Advances, 4(19), 4693–4738.
8. Klok, F. A., Piazza, G., Sharp, A. S., Ainle, F. N., Jaff, M. R. et al. (2022). Ultrasound-facilitated, catheter-directed thrombolysis vs anticoagulation alone for acute intermediate-high-risk pulmonary embolism: Rationale and design of the HI-PEITHO study. American Heart Journal, 251, 43–53.
9. He, J., Wang, Z., Zhou, Y. X., Ni, H., Sun, X. et al. (2022). The application of inferior vena cava filters in orthopaedics and current research advances. Frontiers in Bioengineering and Biotechnology, 10, 1045220.
10. Chen, Y., Zhang, P., Deng, X., Fan, Y., Xing, Y. et al. (2017). Improvement of hemodynamic performance using novel helical flow vena cava filter design. Scientific Reports, 7(1), 40724.
11. Déan, C., Kim, Y. I., Sanchez, O., Martelli, N., Sapoval, M. et al. (2022). Safety and efficacy of the VenaTech retrievable inferior vena cava filter: A first-in-man single-center prospective study. CVIR Endovascular, 5(1), 1–8.
12. Gillespie, D. L., Spies, J. B., Siami, F. S., Rectenwald, J. E., White, R. A. et al. (2020). Predicting the safety and effectiveness of inferior vena cava filters study: Design of a unique safety and effectiveness study of inferior vena
cava filters in clinical practice. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 8(2), 187–194.
13. Winokur, R. S., Bassik, N.,Madoff, D. C., Trost, D. (2019). Radiologists’ field guide to retrievable and convertible inferior vena cava filters. American Journal of Roentgenology, 213(4), 768–777.
14. Law, Y., Chan, Y. C., Cheng, S. W. K. (2018). Epidemiological updates of venous thromboembolism in a Chinese population. Asian Journal of Surgery, 41(2), 176–182.
15. Wang, S. L., Siddiqui, A., Rosenthal, E. (2016). Long-term complications of inferior vena cava filters. Journal of Vascular Surgery Venous & Lymphatic Disorders, 5(1), 33–41.
16. Hohenwalter, E. J., Stone, J. R., O’Moore, P. V., Smith, S. J., Selby, J. B. et al. (2017). Multicenter trial of the VenaTech convertible vena cava filter. Journal of Vascular and Interventional Radiology, 28(10), 1353–1362.
17. Sheahan, K. P., Tong, E., Lee, M. J. (2023). A review of inferior vena cava filters. The British Journal of Radiology, 96(1141), 20211125.
18. Huang, S. Y., Damasco, J. A., Tian, L., Lu, L., Melancon, M. P. (2020). In vivo performance of gold nanoparticleloaded absorbable inferior vena cava filters in a swine model. Biomaterials Science, 8(14), 3966–3978.
19. Shahid, M. U., Nirgudkar, N., Chandra, V., Gonzales, S., Kumar, A. (2022). Influence of exercise on inferior vena cava wall interaction with inferior vena cava filters: Results of a pilot in vivo porcine study. The Arab Journal of Interventional Radiology, 6(2), 72–75.
20. Stewart, S. F. C., Robinson, R. A., Nelson, R. A., Malinauskas, R. A. (2008). Effects of thrombosed vena cava filters on blood flow: Flow visualization and numerical modeling. Annals of Biomedical Engineering, 36(11), 1764–1781.
21. Turitto, V. T., Hall, C. L. (1998). Mechanical factors affecting hemostasis and thrombosis. Thrombosis Research, 92(6), S25–S31.
22. Lopez, J. M., Fortuny, G., Puigjaner, D., Herrero, J.,Marimon, F. (2018). A comparative CFD study of four inferior vena cava filters. International Journal for Numerical Methods in Biomedical Engineering, 34(7), e2990.
23. Singer, M. A., Wang, S. L. (2011). Modeling blood flow in a tilted inferior vena cava filter: Does tilt adversely affect hemodynamics? Journal of Vascular and Interventional Radiology, 22(2), 229–235.
24. Prince, M. R., Novelline, R. A., Athanasoulis, C. A., Simon, M. (1983). The diameter of the inferior vena cava and its implications for the use of vena caval filters. Radiology, 149(3), 687–689.
25. Dowell, J. D., Castle, J. C., Schickel, M., Andersson, U. K., Zielinski, R. et al. (2015). Celect inferior vena cava wall strut perforation begets additional strut perforation. Journal of Vascular and Interventional Radiology, 26(10), 1510–1518.
26. Aycock, K. I., Campbell, R. L., Manning, K. B., Sastry, S. P., Shontz, S. M. et al. (2014). A computational method for predicting inferior vena cava filter performance on a patient-specific basis. Journal of Biomechanical Engineering, 136(8), 081003.
27. Leask, R. L., Johnston, K. W., Ojha, M. (2004). Hemodynamic effects of clot entrapment in the TrapEase inferior vena cava filter. Journal of Vascular & Interventional Radiology, 15(5), 485–490.
28. Tedaldi, E., Montanari, C., Aycock, K. I., Sturla, F., Redaelli, A. et al. (2018). An experimental and computational study of the inferior vena cava hemodynamics under respiratory-induced collapse of the infrarenal IVC. Medical Engineering & Physics, 54, 44–55.
29. Wang, J., Huang,W., Zhou, Y., Han, F., Ke, D. et al. (2020). Hemodynamic analysis of VenaTech convertible vena cava filter using computational fluid dynamics. Frontiers in Bioengineering and Biotechnology, 8, 556110.
30. Li, M., Wang, J., Huang, W., Zhou, Y., Song, X. (2022). Evaluation of hemodynamic effects of different inferior vena cava filter heads using computational fluid dynamics. Frontiers in Bioengineering and Biotechnology, 10, 1034120.
31. Amiri, M. H., Keshavarzi, A., Karimipour, A., Bahiraei, M., Goodarzi, M. et al. (2019). A 3-D numerical simulation of non-Newtonian blood flow through femoral artery bifurcation with a moderate arteriosclerosis: Investigating Newtonian/non-Newtonian flow and its effects on elastic vessel walls. Heat and Mass Transfer, 55, 2037–2047.
32. Lopez, J. M., Fortuny, G., Puigjaner, D., Herrero, J., Marimon, F. (2020). Hemodynamic effects of blood clots trapped by an inferior vena cava filter. International Journal for Numerical Methods in Biomedical Engineering, 36(7), e3343.
33. Boniforti, M. A., Magini, R., Orosco Salinas, T. (2023). Hemodynamic investigation of the flow diverter treatment of intracranial aneurysm. Fluids, 8(7), 189.
34. Hassan, M., Issakhov, A., Khan, S. U. D., Assad, M. E. H., Hani, E. H. B. et al. (2020). The effects of zero and high shear rates viscosities on the transportation of heat and mass in boundary layer regions: A non-Newtonian fluid with carreau model. Journal of Molecular Liquids, 317, 113991.
35. Baraikan, A. A., Czechowicz, K., Morris, P. D., Halliday, I., Gosling, R. C. et al. (2023). Modelling the hemodynamics of coronary ischemia. Fluids, 8(5), 159.
36. Cheng, C. P., Herfkens, R. J., Taylor, C. A. (2003). Inferior vena caval hemodynamics quantified in vivo at rest and during cycling exercise using magnetic resonance imaging. American Journal of Physiology-Heart & Circulatory Physiology, 284(4), H1161–H1167.
37. Gallagher, M. B., Aycock, K. I., Craven, B. A., Manning, K. B. (2018). Steady flow in a patient-averaged inferior vena cava—Part I: Particle image velocimetry measurements at rest and exercise conditions. Cardiovascular Engineering and Technology, 9(4), 641–653.
38. Selimli, S. (2022). Investigation the helical strut attached vena cava filter hemodynamic performance. Journal of Engineering Research, 10(2B), 174–183.
39. Lurie, J. M., Png, C. M., Subramaniam, S., Chen, S., Chapman, E. et al. (2019). Virchow’s triad in “silent” deep vein thrombosis. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 7(5), 640–645.
40. Lowe, G. D. (2003). Virchow’s triad revisited: Abnormal flow. Pathophysiology of Haemostasis and Thrombosis, 33(5–6), 455–457.
41. Bovill, E. G., Vliet, A. V. D. (2011). Venous valvular stasis–associated hypoxia and thrombosis: What is the link? Annual Review of Physiology, 73(1), 527–545.
42. McCowan, T. C., Ferris, E. J., Carver, D. K. (1990). Inferior vena caval filter thrombi: Evaluation with intravascular US. Radiology, 177(3), 783–788.
43. Li, X., Haddadin, I., McLennan, G., Farivar, B., Staub, D. et al. (2020). Inferior vena cava filter–comprehensive overview of current indications, techniques, complications and retrieval rates. European Journal of Vascular Medicine, 49(6), 449–462.
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