Staging of fixation and retrievability of Greenfield filters

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Presentation transcript:

Staging of fixation and retrievability of Greenfield filters Lazar J. Greenfield, MD, Mary C. Proctor, MS, Eric A. James, BS, Gerald D. Abrams, MD, Mohammed M. Moursi, MD Journal of Vascular Surgery Volume 20, Issue 5, Pages 744-750 (November 1994) DOI: 10.1016/S0741-5214(94)70162-8 Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Models of Greenfield filter include TGF-MH (left), SGF (center) and prototype SGF-MH (right) for percutaneous insertion. Journal of Vascular Surgery 1994 20, 744-750DOI: (10.1016/S0741-5214(94)70162-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 In latest prototype of percutaneous SGF, recurved hooks are configured so that two are directed down, whereas four are directed up Journal of Vascular Surgery 1994 20, 744-750DOI: (10.1016/S0741-5214(94)70162-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Prototypical retrieval units designed to accommodate 12F (left) and standard (24F) Greenfield filters (right). Hook is attached to inner catheter that moves to capture filter and hold it for retrieval (Fig. 4). Journal of Vascular Surgery 1994 20, 744-750DOI: (10.1016/S0741-5214(94)70162-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Once apex of SGF is snared (left), hood is advanced over filter, releasing it from iliac vein (center), and filter is withdrawn into capsule (right). Journal of Vascular Surgery 1994 20, 744-750DOI: (10.1016/S0741-5214(94)70162-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Supplementary hook fashioned from stiff end of 0.035-inch guidewire proved useful for capture of filter apex. Journal of Vascular Surgery 1994 20, 744-750DOI: (10.1016/S0741-5214(94)70162-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 During retrieval of SGF-MH 7 days after placement in this animal, tricuspid valve was damaged (scissor point), papillary muscle was detached, and ventricle was perforated (clamp). Journal of Vascular Surgery 1994 20, 744-750DOI: (10.1016/S0741-5214(94)70162-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Photomicrograph of control animal insertion site in iliac vein at 21 days. Vein wall (above) is indented by filter hook. Between hooks and lumen (below) is thickened, cellular intima. (Hematoxylin-eosin; original magnification ×30.) Journal of Vascular Surgery 1994 20, 744-750DOI: (10.1016/S0741-5214(94)70162-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions