What is the role of contrast venography in the workup of inferior vena cava thrombosis (IVCT)?

Updated: Jun 12, 2018
  • Author: Luis G Fernandez, MD, FACS, FASAS, FCCP, FCCM, FICS, KHS, KCOEG; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

This imaging modality is the criterion standard for diagnosis of DVT. Two access sites may be required to document the extent of a thrombus in situations of IVC occlusion by clot. However, the caudal extent of the clot may be overestimated because of preferential flow into collaterals.

Advantages of contrast venography include the following:

  • Limited false-positive study results
  • Access for therapy, thrombolytic agents, or caval interrupting device
  • Access for pulmonary angiography (if indicated)

Disadvantages of this technique include the following:

  • Invasiveness
  • Possible need for more than one puncture
  • Possibility of postprocedural DVT

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