Journal of Surgery Concepts & Practice >
Value of contrast-enhanced ultrasound in diagnosis of thrombus in inferior vena cava filter
Received date: 2023-12-21
Online published: 2025-01-23
Objective To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in assessing thrombus of inferior vena cava filters before filters removal. Methods We analyzed 127 patients who scheduled for inferior vena cava filter extraction from June to November 2023, 53 of which underwent CEUS examination. The enhancement of contrast agent signal within and around the filter was observed under CEUS mode. The thrombus was classified based on the signal loss of contrast agent and then compared with digital subtraction angiography(DSA). Results In the CEUS mode, the contrast agent was visualized within the inferior vena cava, clearly revealing signal loss for the thrombus location. Based on the size and location of the thrombus, filter thrombus was categorized into four groups: 41 cases of type 0, 8 cases of type Ⅰ, 3 cases of type Ⅱ, and 1 case of type Ⅲ. No significant difference in thrombus classification was observed between CEUS and DSA (P>0.05). According to the classification of filter thrombus, different extraction schemes were applied to 53 patients with inferior vena cava filters. There were no major bleeding events or symptomatic pulmonary embolism happened. Conclusions CEUS is valuable for evaluating filter thrombus prior to removal, providing a basis for preoperative assessment of surgical risks, selection of treatment plans, and prevention of complications.
ZHANG Jian , QIAN Weiqing , YI Xiaolei . Value of contrast-enhanced ultrasound in diagnosis of thrombus in inferior vena cava filter[J]. Journal of Surgery Concepts & Practice, 2024 , 29(05) : 441 -445 . DOI: 10.16139/j.1007-9610.2024.05.12
| [1] | DI NISIO M, VAN ES N, BüLLER H R. Deep vein thrombosis and pulmonary embolism[J]. Lancet, 2016, 388(10063):3060-3073. |
| [2] | WHITE R H. The epidemiology of venous thromboembolism[J]. Circulation, 2003, 107(23Suppl 1): 14-18. |
| [3] | KONSTANTINIDES S V, MEYER G, BECATTINI C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)[J]. Eur Heart J,2020, 41(4):543-603. |
| [4] | KAKKOS S K, GOHEL M, BAEKGAARD N, et al. Editor's choice - European Society for Vascular Surgery (ESVS) 2021 clinical practice guidelines on the management of venous thrombosis[J]. Eur J Vasc Endovasc Surg,2021,61(1):9-82. |
| [5] | MAHRER A, ZIPPEL D, GARNIEK A, et al. Retrievable vena cava filters in major trauma patients: prevalence of thrombus within the filter[J]. Cardiovasc Intervent Radiol, 2008, 31(4):785-789. |
| [6] | 中国医师协会介入医师分会, 中华医学会放射学分会介入专业委员会, 中国静脉介入联盟. 下腔静脉滤器置入术和取出术规范的专家共识(第2版)[J]. 中华医学杂志, 2020, 100(27):2092-2101. |
| Radiology Branch of Chinese Medical Association, Intervention Professional Committee of Radiology Branch of Chinese Medical Association, China Venous Intervention Alliance. Expert consensus on standards for inferior vena cava filter implantation and retrieval (2nd edition)[J]. Natl Med J China, 2020, 100 (27):2092-2101. | |
| [7] | KIM M, LEE S Y, CHA J G, et al. Single center expe-rience of inferior vena cava filter retrieval in trauma patients: contrast-enhanced CT-based retrieval within hospital stay[J]. Clin Imaging, 2021,79:43-47. |
| [8] | HUANG J, DAI X, ZHANG X, et al. Retrievable inferior vena cava filter to prevent pulmonary embolism in patients with fractures and deep venous thrombosis of lower extremities: a single-center experience[J]. J Int Med Res, 2021, 49(4):3000605211006591. |
| [9] | 赵伯翔, 顾建平, 何旭, 等. 下腔静脉滤器长期留置并发症 CT随访的单中心研究[J]. 介入放射学杂志, 2016, 25(11):944-948. |
| ZHAO B X, GU J P, HE X, et al. Follow-up checkups with CT scan for the complications induced by long-term retention of indwelling IVC filters: a single-center study[J]. J Interventional Radiol, 2016, 25(11): 944-948. | |
| [10] | GOLEMATI S, COKKINOS D D. Recent advances in vascular ultrasound imaging technology and their clinical implications[J]. Ultrasonics, 2022,119:106599. |
| [11] | PAN Y, ZHAO J, MEI J, et al. Retrievable inferior vena cava filters in trauma patients: prevalence and management of thrombus within the filter[J]. Eur J Vasc Endovasc Surg, 2016, 52(6):830-837. |
| [12] | 中华医学会外科学分会血管外科学组. 腔静脉滤器临床应用指南[J]. 中国实用外科杂志, 2019, 39(7):651-654. |
| Vascular Surgery Group of the Surgery Branch of Chinese Medical Association. Clinical application guidelines for vena cava filters[J]. Chin J Pract Surg, 2019, 39(7):651-654. | |
| [13] | ANGEL L F, TAPSON V, GALGON R E, et al. Systematic review of the use of retrievable inferior vena cava filters[J]. J Vasc Interv Radiol, 2011, 22(11):1522-1530.e3. |
| [14] | SPISS V, LOIZIDES A, PLAIKNER M, et al. Contrast enhanced ultrasound of the lower limb deep venous system: a technical feasibility study. Technical innovation[J]. Med Ultrason, 2011, 13(4):267-271. |
| [15] | STANESCU D A. Is there a place of contrast-enhanced ultrasonography in deep vein thrombosis?[J]. Med Ultrason, 2011, 13(4):265-266. |
| [16] | SMITH A, PARKER P, BYASS O, et al. Contrast sonovenography - is this the answer to complex deep vein thrombosis imaging?[J]. Ultrasound, 2016, 24(1):17-22. |
| [17] | YAN J P, LI W Q, WANG Z F, et al. Application of contrast-enhanced ultrasound before inferior vena cava filter recovery[J]. Int Angiol, 2017, 36(5):474-481. |
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