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Chapter 43,394

Inferior vena cavography after partial caval occlusion

Turner, M.J.; Gardner, A.M.

British Journal of Radiology 41(486): 417-423

1968


ISSN/ISBN: 0007-1285
PMID: 5659149
DOI: 10.1259/0007-1285-41-486-417
Accession: 043393196

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Partial surgical occlusion of the inferior vena cava, either by plication or caval clip, was undertaken in 39 patients to prevent pulmonary embolism. Post-operative cavograms are presented and the radiological signs of patency and obstruction of the larger veins are described. In approximately 4/5 of the patients the cava remained patent, though narrowed. Obstruction of the large veins may be due to internal thrombosis or extrinsic pressure. The radiological appearance of intravenous thrombus is demonstrated, and the extensive collateral circulation which accompanies caval obstruction is illustrated. Changes in the venogra-phic features over a period of time are described. The effect of respiration on the radiographic appearances during cavography is also mentioned. The effectiveness of the operation of partial caval occlusion, whether by plication or caval clip, is shown. These procedures achieve their object in reducing the caval diameter and lessening the likelihood of pulmonary embolism, with less circulatory disturbance than occurs after caval ligation.