Respiratory-Induced Haemodynamic Changes: A Contributing Factor to IVC Filter Penetration

Purpose The purpose of the study is to evaluate the influence of respiratory-induced vena caval hemodynamic changes on filter migration/penetration. Materials and Methods After placement of either a Gunther Tulip or Celect IVC filter, 101 consecutive patients scheduled for filter retrieval were prospectively enrolled in this study. Pre-retrieval CT scans were used to assess filter complications and to calculate cross-sectional area in three locations: at level of filter strut fixation, 3 cm above and 3 cm below. A 3D finite element simulation was constructed on these data and direct IVC pressure was recorded during filter retrieval. Cross-sectional areas and pressures of the vena cava were measured during neutral breathing and in Valsalva maneuver and identified filter complications were recorded. A statistical analysis of these variables was then performed. Results During Valsalva maneuvers, a 60 % decrease of the IVC cross-sectional area and a fivefold increase in the IVC pressure were identified ( p