Comparison of bedside transabdominal duplex ultrasound versus contrast venography for inferior vena cava filter placement: What is the best imaging modality?

Matthew A. Corriere, Marc A. Passman, Raul J. Guzman, Jeffery Dattilo, Thomas C. Naslund

    Research output: Contribution to journalArticle

    25 Citations (Scopus)

    Abstract

    While contrast venography is considered the gold standard for imaging prior to inferior vena cava (IVC) filter insertion, bedside placement via transabdominal duplex ultrasound (DUS) has been recognized as a safe and effective alternative. To date, there has been no direct comparison of the efficacy of both imaging modalities for IVC filter placement. A concurrent cohort of patients who underwent IVC filter placement at a single institution over a 7-year period with either contrast venography or transabdominal DUS performed at bedside was retrospectively reviewed. Patient demographics, venous thromboembolism risk factors, indications, technical success, and procedural complications were compared. Of 439 patients initially imaged with transabdominal DUS, IVC filter placement was determined to be technically feasible in 382 patients (87%). The procedural technical success rate for IVC filter placement using transabdominal DUS when IVC visualization was adequate was 97.4% (n = 382 patients), compared to 99.7% (n = 318 patients) for contrast venography (p = 0.018). Patients undergoing IVC filter placement with transabdominal DUS more commonly required IVC filter for venous thromboembolism prophylaxis (81.1% vs. 27.8%, p < 0.001), had increased incidence of multiple traumatic injuries (28% vs. 10%, p < 0.001), and had increased risk from immobilization (91.3% vs. 34.1%, p < 0.001). Overall complication rates were 0.6% for venography and 1.8% for transabdominal DUS (p = NS). When IVC visualization was adequate, contrast venography and transabdominal duplex ultrasound both had high rates of success and a low incidence of complications. A technical success advantage was observed for contrast venography; this difference in technical success must be weighed against the bedside insertion advantage offered by DUS, which may be especially important in the immobilized or critically ill patient. Transabdominal DUS remains our preferred technique when feasible, especially when bedside placement is desired.

    Original languageEnglish (US)
    Pages (from-to)229-234
    Number of pages6
    JournalAnnals of Vascular Surgery
    Volume19
    Issue number2
    DOIs
    StatePublished - Jan 1 2005

    Fingerprint

    Vena Cava Filters
    Phlebography
    Venous Thromboembolism
    Inferior Vena Cava
    Multiple Trauma
    Incidence
    Critical Illness
    Immobilization
    Demography

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Cardiology and Cardiovascular Medicine

    Cite this

    Comparison of bedside transabdominal duplex ultrasound versus contrast venography for inferior vena cava filter placement : What is the best imaging modality? / Corriere, Matthew A.; Passman, Marc A.; Guzman, Raul J.; Dattilo, Jeffery; Naslund, Thomas C.

    In: Annals of Vascular Surgery, Vol. 19, No. 2, 01.01.2005, p. 229-234.

    Research output: Contribution to journalArticle

    Corriere, Matthew A. ; Passman, Marc A. ; Guzman, Raul J. ; Dattilo, Jeffery ; Naslund, Thomas C. / Comparison of bedside transabdominal duplex ultrasound versus contrast venography for inferior vena cava filter placement : What is the best imaging modality?. In: Annals of Vascular Surgery. 2005 ; Vol. 19, No. 2. pp. 229-234.
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    abstract = "While contrast venography is considered the gold standard for imaging prior to inferior vena cava (IVC) filter insertion, bedside placement via transabdominal duplex ultrasound (DUS) has been recognized as a safe and effective alternative. To date, there has been no direct comparison of the efficacy of both imaging modalities for IVC filter placement. A concurrent cohort of patients who underwent IVC filter placement at a single institution over a 7-year period with either contrast venography or transabdominal DUS performed at bedside was retrospectively reviewed. Patient demographics, venous thromboembolism risk factors, indications, technical success, and procedural complications were compared. Of 439 patients initially imaged with transabdominal DUS, IVC filter placement was determined to be technically feasible in 382 patients (87{\%}). The procedural technical success rate for IVC filter placement using transabdominal DUS when IVC visualization was adequate was 97.4{\%} (n = 382 patients), compared to 99.7{\%} (n = 318 patients) for contrast venography (p = 0.018). Patients undergoing IVC filter placement with transabdominal DUS more commonly required IVC filter for venous thromboembolism prophylaxis (81.1{\%} vs. 27.8{\%}, p < 0.001), had increased incidence of multiple traumatic injuries (28{\%} vs. 10{\%}, p < 0.001), and had increased risk from immobilization (91.3{\%} vs. 34.1{\%}, p < 0.001). Overall complication rates were 0.6{\%} for venography and 1.8{\%} for transabdominal DUS (p = NS). When IVC visualization was adequate, contrast venography and transabdominal duplex ultrasound both had high rates of success and a low incidence of complications. A technical success advantage was observed for contrast venography; this difference in technical success must be weighed against the bedside insertion advantage offered by DUS, which may be especially important in the immobilized or critically ill patient. Transabdominal DUS remains our preferred technique when feasible, especially when bedside placement is desired.",
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