The Simon Nitinol Filter: Evaluation by MR and Ultrasound

In this prospective blinded study of inferior vena caval (IVC) patency, 18 patients underwent 25 duplex ultrasound (US) and magnetic resonance (MR) angiography examinations over an eight-month period following Simon nitinol filter placement. Clinical examination for lower extremity venous stasis and...

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Bibliographic Details
Published in:Angiology 1992-07, Vol.43 (7), p.541-548
Main Authors: Kim, Ducksoo, Edelman, Robert R., Margolin, Chaim J., Porter, David H., McArdle, Colin R., Schlam, Bertrand W., Gianturco, Laurie E., Siegel, Jeffrey B., Simon, Morris
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alloys
Biological and medical sciences
Evaluation Studies as Topic
Female
Humans
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Prospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Thrombosis - diagnosis
Thrombosis - diagnostic imaging
Ultrasonography
Vascular Patency
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
Vena Cava Filters
Vena Cava, Inferior - diagnostic imaging
Vena Cava, Inferior - pathology
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Summary:In this prospective blinded study of inferior vena caval (IVC) patency, 18 patients underwent 25 duplex ultrasound (US) and magnetic resonance (MR) angiography examinations over an eight-month period following Simon nitinol filter placement. Clinical examination for lower extremity venous stasis and plain abdominal radiography were also performed. Twenty-three of 24 MR ex aminations and 11 of 24 US examinations were judged technically adequate by the blinded observers. One technically adequate US exam was false positive for intraluminal caval thrombus. Thirteen technically inadequate US examinations missed 3 complete caval occlusions and 2 partial occlusions. MR identified all patients with complete or partial caval occlusion. The authors conclude that duplex US reliably confirms IVC patency only when strict criteria for technical adequacy and interpretation are met (good visualization of filter and IVC above and below filter). MR, although expensive, more reliably identifies nonoccluding intraluminal thrombus and caval occlu sion. It should be the noninvasive study of choice in symptomatic patients with venous stasis and patients with recurrent pulmonary emboli.
ISSN:0003-3197
1940-1574
DOI:10.1177/000331979204300701