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Related Experiment Videos

Vena cava duplex imaging before caval interruption

M Friedland1, A Kazmers, R Kline

  • 1Division of Vascular Surgery, Harper Hospital, Detroit, MI 48201, USA.

Journal of Vascular Surgery
|October 1, 1996
PubMed
Summary
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Duplex ultrasonography accurately assesses the inferior vena cava (IVC) for size and patency before Greenfield filter (GF) placement. This imaging technique is a reliable alternative to venacavography for pre-procedural IVC evaluation.

Area of Science:

  • Vascular imaging
  • Interventional radiology
  • Deep vein thrombosis management

Background:

  • Venacavography is standard for evaluating the inferior vena cava (IVC) prior to filter placement.
  • Assessing IVC size, patency, and thrombus presence is crucial for safe filter insertion.
  • Alternative imaging modalities are sought to streamline pre-procedural assessment.

Purpose of the Study:

  • To evaluate the diagnostic capability of duplex ultrasonography for assessing the IVC.
  • To determine if duplex ultrasonography can adequately evaluate IVC size, patency, and thrombus before Greenfield filter (GF) insertion.

Main Methods:

  • Duplex ultrasonography was performed on 40 patients with deep venous thrombosis before GF placement.
  • IVC diameters were measured, and patency, thrombus, and anomalies were assessed.

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  • Venacavography was used as a reference standard for comparison.

    • Main Results:

    • Duplex ultrasonography demonstrated high accuracy (97.5%) in measuring IVC diameter compared to venacavography.
    • Sensitivity and positive predictive value for detecting a transverse diameter ≤26 mm were 97.5% and 100%, respectively.
    • IVC thrombus was correctly identified by duplex in two patients, confirmed by venacavography.

    Conclusions:

    • Duplex ultrasonography is a valuable and accurate tool for pre-procedural IVC assessment.
    • It can reliably evaluate IVC size, patency, and thrombus before Greenfield filter placement.
    • This technique offers a practical alternative to routine venacavography.