Ultrasound in evaluation of post-interventional femoral vein obstruction: a case report

Abstract

Ultrasound is the preferred imaging modality in diagnosis of vascular complications following cardiac catheterization and intervention. In some cases, however, bleeding surrounding the femoral vessels, may severely distort the color Doppler images, making detection of venous complications especially difficult. This report refers to such a case where post-catheterization haematoma was suspected to cause an obstruction of the femoral vein. Spectral Doppler recordings of blood flow in the common femoral vein, up-stream, distal to the hemorrhagic area, confirmed the diagnosis of obstruction by demonstrating changes in the venous flow pattern in the common femoral vein, consistent with venous hypertension. Due to the poor quality of the ultrasound images, the exact cause of the obstruction had to be established by another imaging modality, not affected by haemorrhages. CT showed that the common femoral vein was compressed at the puncture site by surrounding haemorrhages. Thus, when bleeding due to cardiac catheterization is associated with possible venous obstruction and findings by color Doppler are equivocal due to degradation of the color-Doppler image, detection of venous hypertension by spectral Doppler, performed distal to the bleeding area, strongly supports the presence of venous obstruction where the exact cause may be established by CT.

In‐plane guided upper arm arteriovenous fistula cannulation with color ultrasound

“…20 It is a practical tool to assist the visualization of blood vessels in clinical practice, and it has been applied to PICC cannulation 21 and deep vein catheterization. 22,23 We took the advantages of color Doppler ultrasound long-axis display for in-plane guided cannulation in upper extremity AVF. Our data demonstrated that ultrasonic-assisted improved the one-time cannulation success rate and patient satisfaction.…”

“…Color Doppler ultrasound can clearly and dynamically display the inner diameter, depth, direction, branches, and blood flow of blood vessels, which is widely used in the assessment of patients' blood vessels 20 . It is a practical tool to assist the visualization of blood vessels in clinical practice, and it has been applied to PICC cannulation 21 and deep vein catheterization 22,23 . We took the advantages of color Doppler ultrasound long‐axis display for in‐plane guided cannulation in upper extremity AVF.…”