Three-Dimensional Rotational Angiography of the Inferior Vena Cava as an Adjunct to Inferior Vena Cava Filter Retrieval

Journal Article · Thu Jan 15 04:00:00 EST 2009 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-008-9405-6· OSTI ID:21426324

Bozlar, Ugur; Edmunds, J Stewart; Turba, Ulku C; Hartwell, Gary D; Housseini, Ahmed M

The objective of this study was to explore the role of three-dimensional (3-D) rotational angiography (RA) of the inferior vena cava (IVC; 3-D CV) before filter retrieval and its impact on treatment planning compared with standard anteroposterior cavography (sCV). Thirty patients underwent sCV and 3-D CV before IVC filter retrieval. Parameters assessed were: projection of filter arms or legs beyond the caval lumen, thrombus burden within the filter and IVC, and orientation of the filter within IVC. Skin and effective radiation doses were calculated. Statistical analysis was performed using paired Student t test and nonparametric McNemar's test. Standard anteroposterior cavography detected 49 filter arms or legs projecting beyond the caval lumen in 25 patients. Three-dimensional CV demonstrated 89 filter arms or legs projecting beyond the caval lumen in 28 patients. Twenty-two patients had additional filter arms or legs projecting beyond the caval lumen detected on 3-D CV that were not detected on sCV (p < 0.001). Filter apex tilt detection differed significantly (p < 0.001) between sCV and 3-D CV, with 3-D CV being more accurate. The filter apex abutted the IVC wall in 10 patients (33%) on 3-D CV, but this was diagnosed in only 3 patients (10%) with sCV. Thrombus was detected in 8 patients (27%), 1 thrombus of which was seen only on 3-D CV, and treatment was changed in this patient because of thrombus size. Mean effective radiation doses for 3-D CV were approximately two times higher than for sCV (1.68 vs. 0.86 mSv), whereas skin doses were three times lower (12.87 vs. 35.86 mGy). Compared with sCV, performing 3-D CV before optional IVC filter retrieval has the potential to improve assessment of filter arms or legs projecting beyond the caval lumen, filter orientation, and thrombus burden.

• OSTI ID: 21426324
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 1 Vol. 32; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ARMS
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
DOSES
FILTERS
LEGS
LIMBS
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIATION DOSES
RADIOLOGY
SKIN
THREE-DIMENSIONAL CALCULATIONS
VEINS