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Inferior vena caval filter thrombi: evaluation with intravascular US
T C McCowan1, E J Ferris, D K Carver
1Department of Radiology, University of Arkansas for Medical Sciences, Little Rock 72205.
Radiology
|December 1, 1990
Summary
Intravascular ultrasound effectively detects thrombi in inferior vena cava filters, outperforming traditional cavography and external ultrasound. This minimally invasive technique shows promise for IVC filter evaluation.
Area of Science:
- Medical Imaging
- Vascular Surgery
- Interventional Radiology
Background:
- Inferior vena cava (IVC) filters are crucial for preventing pulmonary embolism.
- Accurate detection of thrombus within IVC filters is essential for patient management.
- Existing imaging modalities have limitations in visualizing filter-associated thrombi.
Purpose of the Study:
- To evaluate the efficacy of 20-MHz intravascular ultrasound (IVUS) for detecting thrombi in IVC filters.
- To compare IVUS performance against positive-contrast cavography and external duplex ultrasound.
- To assess the safety and feasibility of IVUS in clinical settings.
Main Methods:
- In vitro study of six IVC filter models using IVUS.
- In vivo evaluation of IVC filters in 23 patients (25 procedures).
- Comparison of IVUS findings with simultaneous positive-contrast cavograms.
Main Results:
- IVUS demonstrated characteristic patterns for different IVC filters.
- Small experimental thrombi (0.5 cm3) were readily detected in vitro.
- IVUS showed equal or superior performance compared to cavography in 11 cases.
- IVUS was superior to external duplex ultrasound in all 21 comparative cases.
- No complications were reported with IVUS use.
Conclusions:
- 20-MHz IVUS is a sensitive and specific tool for detecting thrombi in IVC filters.
- IVUS offers advantages over cavography and external duplex ultrasound for IVC filter assessment.
- IVUS is a safe and effective imaging modality for evaluating IVC filters.