Phlebography – ABC CARDIOL

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Case Report

Traumatic Laceration of Left Common Iliac Vein during Catheter Ablation — An Unusual Presentation of Cockett-May-Thurner Syndrome

Thiago Almeida Barroso et al. Simone Nascimento dos Santos Fabio Botelho Benhur David Henz … Arnaldo C. Barreto Filho André Rodrigues Zanatta Luiz Roberto Leite

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Original Article

Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures

Caio Marcos de Moraes Albertini et al. Katia Regina da Silva Joaquim Maurício da Motta Leal Filho Elizabeth Sartori Crevelari … Martino Martinelli Filho Francisco Cesar Carnevale Roberto Costa

Abstract

Background:

Venous obstructions are common in patients with transvenous cardiac implantable electronic devices, but they rarely cause immediate clinical problems. The main consequence of these lesions is the difficulty in obtaining venous access for additional leads implantation.

Objectives:

We aimed to assess the prevalence and predictor factors of venous lesions in patients referred to lead reoperations, and to define the role of preoperative venography in the planning of these procedures.

Methods:

From April 2013 to July 2016, contrast venography was performed in 100 patients referred to device upgrade, revision and lead extraction. Venous lesions were classified as non-significant (< 50%), moderate stenosis (51-70%), severe stenosis (71-99%) or occlusion (100%). Collateral circulation was classified as absent, discrete, moderate or accentuated. The surgical strategy was defined according to the result of the preoperative venography. Univariate analysis was used to investigate predictor factors related to the occurrence of these lesions, with 5% of significance level.

Results:

Moderate venous stenosis was observed in 23%, severe in 13% and occlusions in 11%. There were no significant differences in relation to the device side or the venous segment. The usefulness of the preoperative venography to define the operative tactic was proven, and in 99% of the cases, the established surgical strategy could be performed according to plan.

Conclusions:

The prevalence of venous obstruction is high in CIED recipients referred to reoperations. Venography is highly indicated as a preoperative examination for allowing the adequate surgical planning of procedures involving previous transvenous leads.

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Artigo Original

Clinical outcomes after investigation for pulmonary embolism using CT angiography and venography

Eduardo S. Darze et al. João F.M. Braghiroli Ricardo V. Almeida Ênio P. Araújo … Sergio M. Toscano César Augusto Araújo-Neto

BACKGROUND: The diagnosis of pulmonary embolism (PE) still requires long work-up periods and multiple tests. OBJECTIVE: We aim to assess clinical outcomes after a negative investigation using a combined protocol of CT pulmonary angiography and CT venography (CTA/CTV) as a sole diagnostic test in unselected patients with suspected PE. METHODS: This retrospective cohort study enrolled consecutive patients with suspected PE who were investigated with a combined CTA/CTV protocol. Patients who had an initially negative investigation and were not anticoagulated were followed for 6 months for the occurrence of recurrent venous thromboembolic events. RESULTS: Out of 425 patients with suspected PE, 62 (14.6%) had venous thromboembolism diagnosed on the initial CTA/CTV. The mean age was 56 ± 19 years and 61% of the population fell into the low clinical probability category. Isolated deep vein thrombosis represented 21% of all venous thromboembolic events, and when considering the whole population, CTV was associated with an increment in diagnostic yield of 3.1%. Our cohort was composed of 320 patients with initially negative CTA/CTVs and who were not anticoagulated. After 6 months of follow up, only three patients presented with recurrent thromboembolic events (0.9%; 95% CI -0.1% – 2.0%) and none was fatal. There were no PE-related deaths. CONCLUSION: Our study suggests that a diagnostic strategy that utilizes CTA/CTV as a sole diagnostic test can safely rule out PE in a low to moderate risk population and is associated with favorable outcomes with a negative predictive value of 99.1%. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0)

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Traumatic Laceration of Left Common Iliac Vein during Catheter Ablation — An Unusual Presentation of Cockett-May-Thurner Syndrome

Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures

Abstract

Background:

Objectives:

Methods:

Results:

Conclusions:

Clinical outcomes after investigation for pulmonary embolism using CT angiography and venography

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