Experimental comparison of percutaneous vena caval devices: titanium Greenfield filter versus bird's nest filter.

A venous embolism model with autogenous thrombus was used for comparison of the functional properties of two new vena caval devices: a titanium Greenfield filter and the bird's nest filter. All nine Greenfield filters were correctly placed in the inferior vena cava and produced significant clot lysis of 81.3% +/- 16.3% (p less than 0.001, paired t test). Difficulty was encountered in affixing the hooks of the bird's nest device into the vein wall and resulted in two filters not being inserted and two filters being placed too proximally. One set of hooked wires of another bird's nest device migrated to the right atrium despite correct insertion. Eight bird's nest devices allowed clot lysis of 83.4% +/- 17.7% (p less than 0.001), paired t test) but thrombus size was increased in one case. The Greenfield and bird's nest filters have comparable effects on trapped emboli, but the bird's nest filter may be susceptible to thrombosis and occlusion under certain circumstances. The pre-shaped hooked wires of the bird's nest device may be difficult to insert and may allow proximal migration after a large thrombus was trapped.