ABSTRACT
Objective To evaluate multi-slice spiral CT venography (MSCTV) and digital subtraction venography (DSV) in diagnosing iliac vein compression syndrome (IVCS) and secondary thrombosis. Methods The imaging materials, including MSCTV and DSV performed before and after the thrombolysis therapy, of 38 patients with clinically-suspected IVCS were collected. The inner diameters of the compressed iliac veins were measured on MSCTV images and the compression ratio was calculated. Usingχ2 test, the detection rates of IVCS by MSCTV and DSV were compared. Results Of 38 patients, IVCS was detected by MSCTV in 29, by pretreatment DSV in 20 and by post-treatment DSV in 29. The difference in the detection rate of IVCS between MSCTV and pre-treatment DSV was statistically significant (χ2=4.65, 0.010.05). Conclusion For the diagnosis of IVCS, MSCTV is superior to pre-treatment DSV in the diagnostic accuracy of iliac vein compression syndrome. Therefore, MSCTV should be used as the preferred method of examination.(J Intervent Radiol, 2015, 24:301-305)
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Objective To investigate the effect of endovascular treatment to initial and long-term outcomes of postpartum deep venous thrombosis (DVT) . Methods The clinical data, venography and 3-yaer follow up data of 30 female patients with acute or subacute deep vein thrombosis in the postpartum period who received endovascular therapy consisting of catheter-directed thrombolysis with angioplasty (stenting for some patients with iliac vein compression syndrome (IVCS)) were retrospectively evaluated. Clot removal was graded as grade Ⅲ(>95%), grade Ⅱ(50% to 95%), and grade Ⅰ(0.05).For 18 patients with IVCS, there was significant statistical difference between patients implanting stents(initial patency was 100.0%(7/7) and whom not implanting stents(initial patency was 63.6%,7/11) (χ2=5.14, P0.05). Conclusions Endovascular therapy consisting of catheter-directed thrombolysis with angioplasty could be considered as a primary therapeutic procedure in patients with acute or subacute postpartum DVT. Stenting for treatment of iliac compression which contributed to postpartum DVT is very valuable to ensuring higher long-term patency rate.
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Objective To discuss the application of spiral CT angiography in postoperative re-examination of lower limb artery stent implantation. Methods During the period from March 2012 to March 2014 at the Affiliated Nanjing Hospital of Nanjing Medical University, CT angiography was carried out in 67 patients who had received stent implantation for arteriosclerotic occlusion of lower limb. The diseases involved 78 lower limbs, and a total of 85 stents were employed. The volume rendering (VR), maximum intensity projection (MIP), multi-planar reformation (MPR) and curved surface reconstruction (CSR) were performed to stereoscopically display the lesion’s anatomy as well as the implanted stents, and the imaging manifestations were compared with the clinical symptoms and DSA findings. Results Successful examination was accomplished in 65 patients (81 stents in total), and clear images were obtained. Of the 81 stents, no stenosis was seen in 43, Ⅱ - Ⅳ grade stenosis in 32 and complete occlusion in 6. The results were closely correlated with the clinical symptoms. The CT angiography manifestations in 31 patients (34 stents in total) were compared with their DSA performed in two weeks, and the results showed that the stenotic degrees of three stents judged by CT angiography were not consistent with those judged by DSA. The consistent rate of CT angiography was 91.2% when taking DSA as the standard. Conclusion Lower limb arterial CT angiography examination is a safe and non-invasive technique, it can clearly display the stent inner canal. Therefore, this technique is of great value in postoperative re- examination of lower limb artery stent implantation.
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Along with increasing use of inferior vena cava (IVC) filter implantation, more and more attention has been paid to the filter - related complications by scholars both at home and abroad. For the present the generally accepted filter- related complications include filter deformation, filter tilt, filter fracture, filter migration, IVC perforation, IVC thrombosis, IVC occlusion, recurrence of pulmonary embolism, deep vein thrombosis (DVT), post - thrombosis syndrome (PTS), etc. Accurate recognition of filter - related complications and prompt use of appropriate measures that are directed against a given complication in order to reduce or avoid complications are of great clinical significance in applying the inferior vena cava filter to clinical practice in a more safe and effective way. This paper aims to make a comprehensive review about the filter- related complications and the research progress concerning their prevention in recent years.