Denali Flashcards

1
Q

Denali Indications

A

for us in the prevention of recurrent pulmonary embolism via permanent placement in the vena cava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Denali is used when

A
  • anticoagulants are contraindicated
  • failure of anticoagulation therapy
  • emergency treatment following massive PE
  • chronic, recurrent PE where anticoagulant therapy has failed or its contraindicated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

goals of an optional IVC filter

A
  • protect against PE
  • long-term retrievability
  • stability in the vena cava
  • avoid complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what was the first filter to recieve a retrieval indication in the U.S?

A
  • Bard Recovery filter
  • bi-level filtration to trap large and small emboli
  • bullet-tip for retrival with the recovery cone removal system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Order of Bard filter creations

A
  • recovery
  • G2
  • G2 express
  • G2x
  • eclipse
  • Meridian
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how many legs/arms does denali have?

A
  • 6 arms/legs
  • 12 total
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are some design features of denali

A
  • electropolished one-piece nitinol filter body
  • dual level filtration
  • conical design
  • dual-level filtration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

T/F: Denali is both a permanent and retrievable device

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Study Design

A
  • prospective, multicenter, single arm
  • 200 patients followed 2 years post-placement or 30 days post-retrieval
  • reviewed by independant core lab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The technical success for the filter placement is ___, where the clinical success is ___.

A
  • 99.5%
  • 95.0%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

the technical success for filter retrieval is ___, where the clincal is ____.

A
  • 97.6%
  • 99.2%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In the of Denali® Study, what was the mean and max indwell time of the filter?

A

201, 736

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Select 3 significant design differences of Denali vs. previous generations of Bard IVC filters

A
  • one piece body
  • staggered leg lengths
  • robust hook
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What Size sheaths come in our SRK30 Denali retrieval system?

A

9Fr, 11Fr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The filter maintained high retrieval success in ___ patients over indwells of ______ days

A
  • 121
  • 5-736
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

contraindications for denali use

A
  • patients with IVC larger than 28 mm
  • risk of PE
  • uncontrolled sepsis
  • hypersensitivity to nikel-titanium alloys
  • pregnant patients when fluoroscopy may endanger the fetus
17
Q

when should the filter not be retrieved?

A

if there is a significant amount of thrombus near the filter

18
Q

Pulmonary embolism causes death in ___ amount of people

A

30%

19
Q

Ideal placement is

A

1 cm below the renal vein

20
Q

What program is offered in conjunction with Denali filters?

A

reach

21
Q

What is the gold standard for DVT treatment?

A

Anticoagulation

22
Q

What are the 2 radiopaque markers on Denali introducer sheath for?

A

28cm distance used to calibrate fluoro to accurately measure IVC vessel size

23
Q

Pros for femoral access

A
  • may be easier for physican
  • may be less traumatic for patient
  • avoids proximity to the heart
24
Q

cons for femoral access

A
  • may traverse through clot
  • potentially longer recoup time for patient
  • may be more difficult to insert deployment system straight
25
Q

jugular access pros

A
  • may avoid transversing through clot
  • may be easier to insert deployment system straight
  • potentially less recoup time for patient
26
Q

jugular access cons

A
  • may be more difficult to pin wire and deploy
  • must pass near the heart
27
Q

Understand steps in Denali deployment

A

Deployed in 1 smooth continuous motion

28
Q

improper deployment precautions

A
  • if misplacement, sub-optimal placement, or tiliting of the filter occurs, consider immediate removal
  • do not attempt to reposition the filter
29
Q

Argon filter

A

option

30
Q

where denali wins against argon

A
  • clot trapping
  • tilt resistence
  • migration resistence
  • retrieval- snare hook strength
31
Q

cook filter/s

A

tulip, celect

32
Q

off label physican use

A
  • no DVT/PE but at high risk for development
  • “window maker” thrombus with poor respiratory/ pulmonary reserve
  • metastatic disease (cancer)
  • prophylactic placement in high risk surgical patients
  • trauma/ bariatric
  • spinal cord injury
    -severe bone fractures
  • patient who “falls a lot”; unreliable patient