Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2009 Mar 26:7:14.
doi: 10.1186/1476-7120-7-14.

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

Mai Tone Lønnebakken  1 , Eva Gerdts, Jan Wirsching, Ole Martin Pedersen
Affiliations
Case Reports

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

Mai Tone Lønnebakken et al. Cardiovasc Ultrasound. .

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Short axis Power Doppler image showing the right common femoral artery (RCFA) and the non-compressible right femoral vein (RCFV), surrounded by hypoechogenic tissue consisting of perivascular hematoma, at first suspected to represent deep vein thrombosis (DVT).
Figure 2
Figure 2
Spectral Doppler imaging of flow in the right common femoral vein showing persistent high velocity venous flow with loss of normal respiratory synchronous variation consistent with "down-stream" venous obstruction.
Figure 3
Figure 3
Spectral Doppler imaging of normal venous flow in the left common femoral vein (LCFV), characterized by normal velocities, that vary synchronous with respiration.
Figure 4
Figure 4
CT image demonstrating the external compression of the right common femoral vein compared by the normal left common femoral vein.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Nasser TK, Mohler ER, 3rd, Wilensky RL, Hathaway DR. Pheripheral vascular complications following coronary interventional procedures. Clin Cardiol. 1995;18:609–14. doi: 10.1002/clc.4960181105. - DOI - PubMed
    1. Zahn R, Fromm E, Thoma S, Lotter R, Zander M, Wagner S, et al. Local venous thrombosis after cardiac catheterization. Angiology. 1997;48:1–7. doi: 10.1177/000331979704800101. - DOI - PubMed
    1. Messina LM, Brothers TE, Wakefield TW, Zelenock GB, Lindenauer SM, Greenfield LJ, et al. Clinical characteristics and surgical management of vascular complications in patients undergoing cardiac catheterization: interventional versus diagnostic procedures. J Vasc Surg. 1991;13:593–600. doi: 10.1067/mva.1991.27611. - DOI - PubMed
    1. Hamper UM, Dejong MR, Scoutt LM. Ultrasound evaluation of the lower extremity veins. Radiol Clin North Am. 2007;45:525–547. doi: 10.1016/j.rcl.2007.04.013. - DOI - PubMed
    1. Bach AM, Hann LE. When the common femoral vein is revealed as flattened on spectral Doppler sonography: is it a reliable sign for diagnosis of proximal venous obstruction? AJR Am J Roentgenol. 1997;168:733–736. - PubMed

Publication types

LinkOut - more resources