Abstract
The implantation of inferior vena cava (IVC) filter was a safe and effective therapy for preventing fatal pulmonary embolism. However, there are risks associated with long-term implantation of filters. Retrievable filters are designed to be removed, but may also remain permanently. Retrieval can reduce risk of long-term complications. The difficulty or impossibility of retrieval is still an issue of retrieval filter. The major causes of filters retrieval failure were intimal overgrowth and severely tilted filter with apex embedded into the caval wall. Matrix metalloproteinases (MMPs) play a key role in neointimal hyperplasia. It is documented that neointimal hyperplasia can be reduced by inhibiting MMP activity and hence smooth muscle cell migration. MMP inhibitors (MMPI) can potently inhibit the activity of MMPs. We hypothesize that a drug-eluting filter which contains MMPI may inhibit IVC neointimal hyperplasia and decrease the adhesion between vascular wall and filter struts. After implantation of drug-eluting retrieval filter, MMPI is released slowly at the sites where the filter struts are in contact with the caval wall; the activity of MMPs of caval wall will be inhibited, injury in basement membrane is decreased, migration of SMC maybe reduced, and the release of extracellular matrix maybe lessened. Finally, neointimal hyperplasia maybe inhibited, the adhesion between vascular wall and filter maybe weakened, the success rate maybe increased, and the vascular injury during retrieval maybe reduced. The hypothesis might improve the long-term prognosis of venous thromboembolism patients.
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References
Greenfield, L. J., & Michna, B. A. (1988). Twelve-year clinical experience with the Greenfield vena cava filter. Surgery., 104(4), 706–712.
Pais, S. O., Tobin, K. D., Austin, C. B., & Queral, L. (1988). Percutaneous insertion of Greenfield inferior vena cava filter: Experience with ninety-six patients. Journal of Vascular Surgery, 8(4), 460–464.
Becker, D. M., Philbrick, J. T., & Selby, J. B. (1992). Inferior vena cava filters: Indications, safety, effectiveness. Archives of Internal Medicine, 152(10), 1985–1994.
Kinney, T. B. (2003). Update on inferior vena cava filters. Journal of Vascular and Interventional Radiology, 14(4), 425–440.
Berczi, V., Bottomley, J. R., Thomas, S. M., Taneja, S., Gaines, P. A., & Cleveland, T. J. (2007). Long-term retrievability of IVC filters: Should we abandon permanent devices? Cardiovascular and Interventional Radiology, 30(5), 820–827.
PREPIC Study Group. (2005). Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: The PREPIC (Prevention du Risque d’Embolie Pulmonaire par Interruption Cave) randomized study. Circulation, 112(3), 416–422.
Ray, C. E, Jr, Mitchell, E., Zipser, S., Kao, E. Y., Brown, C. F., & Moneta, G. L. (2006). Outcomes with retrievable inferior vena cava filters: A multicenter study. Journal of Vascular and Interventional Radiology, 17(10), 1595–1604.
Durack, J. C., Westphalen, A. C., Kekulawela, S., et al. (2012). Perforation of the IVC: Rule rather than exception after longer indwelling times for the Günther Tulip and Celect retrievable filters. Cardiovascular and Interventional Radiology., 35(2), 299–308.
Kuo, W. T., Cupp, J. S., Louie, J. D., et al. (2012). Complex retrieval of embedded IVC filters: Alternative techniques and histologic tissue analysis. Cardiovascular and Interventional Radiology, 35(3), 588–597.
Oh, J. C., Trerotola, S. O., Dagli, M., et al. (2011). Removal of retrievable inferior vena cava filters with computed tomography findings indicating tenting or penetration of the inferior vena cava wall. Journal of Vascular and Interventional Radiology, 22(1), 70–74.
Rimon, U., Bensaid, P., Golan, G., et al. (2011). Optease vena cava filter optimal indwelling time and retrievability. Cardiovascular and Interventional Radiology, 34(3), 532–535.
Doody, O., Given, M. F., Kavnoudias, H., Street, M., Thomson, K. R., & Lyon, S. M. (2009). Initial experience in 115 patients with the retrievable Cook Celect vena cava filter. Journal of Medical Imaging and Radiation Oncology, 53(1), 64–68.
Lynch, F. C. (2009). Balloon-assisted removal of tilted inferior vena cava filters with embedded tips. Journal of Vascular and Interventional Radiology, 20(9), 1210–1214.
Thors, A., & Muck, P. (2011). Resorbable inferior vena cava filters: Trial in an in vivo porcine model. Journal of Vascular and Interventional Radiology, 22(3), 330–335.
de Gregorio, M. A., Gimeno, M. J., Tobio, R., et al. (2001). Animal experience in the Günther Tulip retrievable inferior vena cava filter. Cardiovascular and Interventional Radiology, 24(6), 413–417.
Dollery, C. M., McEwan, J. R., & Henney, A. M. (1995). Matrix metalloproteinases and cardiovascular disease. Circulation Research, 77, 863–868.
Aguilera, C. M., George, S. J., Johnson, J. L., & Newby, A. C. (2003). Relationship between type IV collagen degradation, metalloproteinase activity and smooth muscle cell migration and proliferation in cultured human saphenous vein. Cardiovascular Research, 58(3), 679–688.
Turner, N. A., Hall, K. T., Ball, S. G., & Porter, K. E. (2007). Selective gene silencing of either MMP-2 or MMP-9 inhibits invasion of human saphenous vein smooth muscle cells. Atherosclerosis., 193(1), 36–43.
George, S. J., Baker, A. H., Angelini, G. D., & Newby, A. C. (1998). Gene transfer of tissue inhibitor of metalloproteinase-2 inhibits metalloproteinase activity and neointima formation in human saphenous veins. Gene Therapy, 5(11), 1552–1560.
Botos, I., Scapozza, L., Zhang, D., Liotta, L. A., & Meyer, E. F. (1996). Batimastat, a potent matrix mealloproteinase inhibitor, exhibits an unexpected mode of binding. Proceedings of National Academy of Science U S A., 93, 2749–2754.
Wong, A. P., Nili, N., & Strauss, B. H. (2005). In vitro differences between venous and arterial-derived smooth muscle cells: Potential modulatory role of decorin. Cardiovascular Research, 65(3), 702–710.
Turner, N. A., Ho, S., Warburton, P., O’Regan, D. J., & Porter, K. E. (2007). Smooth muscle cells cultured from human saphenous vein exhibit increased proliferation, invasion, and mitogen-activated protein kinase activation in vitro compared with paired internal mammary artery cells. Journal of Vascular Surgery, 45(5), 1022–1028.
Iliescu, B., & Haskal, Z. J. (2012). Advanced techniques for removal of retrievable inferior vena cava filters. Cardiovascular and Interventional Radiology, 35(4), 741–750.
Duszak, R. Jr., Parker, L., Levin, D. C., & Rao, V. M. (2011). Placement and removal of inferior vena cava filters: National trends in the medicare population. Journal of the American College of Radiology, 8(7), 483–489.
Kuo, W. T., Odegaard, J. I., Louie, J. D., et al. (2011). Photothermal ablation with the excimer laser sheath technique for embedded inferior vena cava filter removal: Initial results from a prospective study. Journal of Vascular and Interventional Radiology, 22(6), 813–823.
Saito, N., Shimamoto, T., Takeda, T., et al. (2010). Excimer laser-assisted retrieval of Günther Tulip vena cava filters: A pilot study in a canine Model. Journal of Vascular and Interventional Radiology, 21(5), 719–724.
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This article was supported by research grants from the Scientific Research Fund of Liaoning Science and Technology Agency, China (No. 2008225010-5) and the Scientific Research Fund of Liaoning Education Agency, China (No. 2007T183) and the Scientific Research Fund of First Hospital of CMU (No. FSFH1006).
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Liang Xiao and Man Wang contributed equally to this article.
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Xiao, L., Wang, M. MMPI Drug-Eluting IVC Filter Decreases Adhesion Between Caval Wall and Filter. Cell Biochem Biophys 65, 159–161 (2013). https://doi.org/10.1007/s12013-012-9411-9
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DOI: https://doi.org/10.1007/s12013-012-9411-9