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Radionuclide and contrast venography following caval interruption by the Mobin-Uddin umbrella filter
Insights
Radionuclide venography effectively assessed Mobin-Uddin caval filter patency and collateral circulation after pulmonary embolism prevention. Contrast venography was needed to identify specific gonadal veins that could cause recurrent embolism.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Diagnostic Imaging
Background:
- The Mobin-Uddin caval umbrella filter is used to prevent recurrent pulmonary embolism.
- Long-term complications and imaging findings after filter placement require thorough evaluation.
Purpose of the Study:
- To evaluate the effectiveness of radionuclide venography and contrast venography in assessing caval patency and collateral formation after Mobin-Uddin filter insertion.
- To identify potential risk factors for recurrent embolism, such as gonadal vein patency.
Main Methods:
- Nine patients underwent radionuclide venography and/or contrast venography 2 months to 4 years post-filter insertion.
- Analysis focused on caval patency, collateral circulation patterns (central, intermediate, superficial), and gonadal vein visualization.
Main Results:
- Caval occlusion was observed in six of nine patients.
- Three distinct groups of collateral vessels were identified.
- Large gonadal veins, a potential source of recurrent embolism, were noted in two patients.
- Radionuclide venography accurately determined caval patency/occlusion and differentiated collateral types.
- Contrast venography was necessary for precise identification of gonadal veins.
Conclusions:
- Radionuclide venography is a valuable tool for assessing caval patency and collateralization post-Mobin-Uddin filter placement.
- Contrast venography remains essential for detailed visualization of specific venous structures like gonadal veins.
- Imaging findings highlight the importance of evaluating collateral patterns and potential embolic sources in long-term filter management.
Abstract:
Either radionuclide or contrast venography, or both, were performed in nine patients 2 months to 4 years after insertion of Mobin-Uddin caval umbrella filter for prevention of recurrent pulmonary embolism. In six patients the cava was occluded, and three major groups of collaterals were observed (central, intermediate and superficial). Large gonadal veins, which may predispose to recurrent embolism, were seen in two cases. Radionuclide venography gave a clear indication of caval patency or occlusion, and distinguished central from superficial collaterals. Identification of specific gonadal veins required contrast femoral or iliac venography.