Journal of vascular surgery
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Comparative Study
Early duplex scan evaluation of four vena caval interruption devices.
Transvenous inferior vena cava (IVC) filters are used successfully for prevention of pulmonary embolism (PE), but early thrombotic complications such as insertion site thrombosis (IST) and inferior vena cava thrombosis (IVCT) may occur after placement. The frequency of these complications has been uncertain particularly for the wide variety of newer devices. This study was performed to prospectively evaluate IST and IVCT with color-flow venous duplex ultrasound scanning after four IVC filters were placed: the birds' nest filter, the titanium Greenfield filter, the stainless steel Greenfield filter, and the Simon nitinol filter. ⋯ The incidence of thrombotic complications for all devices was higher than has generally been reported. No IVC filter used in this study demonstrated superior performance with regard to these thrombotic complications. As vena cava interruption devices are developed or significantly modified, prospective objective analysis of associated thrombotic complications will allow logical selection for clinical use.
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Transesophageal echocardiography provides detailed images of the thoracic aorta, but imaging of the abdominal aorta and its branches does not occur routinely when the transesophageal echocardiography transducer is advanced into the stomach. Transgastric aortic ultrasonography (TAUS) was investigated as an intraoperative procedure to determine whether transgastric imaging of the abdominal aortic, mesenteric, and renal arteries could be obtained and whether pathologic lesions of these arteries could be identified. ⋯ Intraoperative TAUS is feasible and may be useful for evaluating atherosclerotic disease of the abdominal aorta and renal arteries.
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We have prospectively evaluated the need for serial venous duplex ultrasound examinations in an inpatient population with an initially normal study result. ⋯ Serial follow-up duplex ultrasound evaluation is unnecessary after an initially complete, normal study in patients with symptoms who have suspected pulmonary embolism and nondiagnostic ventilation-perfusion lung scans.