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Upper Extremity Radionuclide Venography in the Diagnosis and Management of Venous Disease Associated with Intravenous Catheters

St. Luke's Episcopal Hospital, Baylor College of Medicine, Houston, Texas

Warren H. Moore

From St. Luke's Episcopal Hospital and Baylor College of Medicine, Houston, Texas

Charles Peters

From St. Luke's Episcopal Hospital and University of Texas Medical School, Houston, Texas

Stanley J. Dudrick

From St. Luke's Episcopal Hospital and University of Texas Medical School, Houston, Texas

Stephen E. Long

From St. Luke's Episcopal Hospital and Baylor College of Medicine, Houston, Texas

The utility of upper extremity ra dionuclide venography (RNV) in the assessment of suspected catheter-re lated central venous thrombosis (CRVT) was evaluated in 40 patients with subclavian venous catheters. Twenty normal patients (Group A) served as controls and their veno graphic patterns were analyzed by using four criteria: (1) delayed tracer transit time, (2) nonuniformity of flow and venous pooling, (3) jugular venous reflux, and (4) collateral ve nous filling. Control studies dis played no collaterals as a distinguishing characteristic but demonstrated the other three fea tures to a variable degree. Of 106 ex tremities suspected of CRVT, 67 (Group B) were initially considered to have normal RNV findings (no col laterals). Contrast venography con firmed a normal pattern in 3 but identified CRVT with collaterals in 3 others. Retrospective review of the RNV studies confirmed faint collat erals in these latter 3. The 39 remain ing extremities (Group C) showed abnormal RNV findings; contrast venography and postmortem studies confirmed the presence of venous dis ease in 5 patients. The authors be lieve that RNV is a reliable, noninvasive procedure for early diag nosis of venous occlusion associated with subclavian venous catheters.

Angiology, Vol. 39, No. 10, 907-914 (1988)
DOI: 10.1177/000331978803901008


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