In vitro performance assessment of distal protection filters: pulsatile flow conditions.

ABSTRACT

PURPOSE: To evaluate in vitro the capture efficiency of a distal protection filter (DPF) used during carotid artery stenting and examine the longitudinal vascular impedance in the presence of a DPF. METHODS: Four approved DPFs (Spider RX, FilterWire EZ, RX Accunet, and FiberNet) were evaluated in a physiologically realistic in vitro setup. A pulsatile programmable piston pump circulated a blood analog at a time-varying flow rate representative of the human common carotid artery. A silicone carotid bifurcation having average human dimensions was used for the carotid flow model. Microspheres ranging from 40 to 900 microm were injected to simulate embolization. The longitudinal vascular impedance was calculated as the ratio of the time-varying pressure gradient across the DPF to the time-varying flow rate in the internal carotid artery. RESULTS: RX Accunet had the highest capture efficiency (99.4%) and Spider RX the lowest (78.1%). Spider RX increased the longitudinal vascular impedance the least after deployment (+23%), while FilterWire EZ increased the longitudinal vascular impedance the least after particles were injected (+29%). FiberNet increased longitudinal vascular impedance the most (+84%). CONCLUSION: This investigation, unique for examining the effects of physiologically realistic pulsatile flow on DPF performance, can aid in the development of future generations of novel DPFs.