Transient Aortoiliac Narrowing during Voluntary Valsalva Maneuver

2019 ◽  
Vol 3 ◽  
pp. 1
Author(s):  
Amit Habbu ◽  
Pritish Bawa ◽  
Kalpita Hatti ◽  
Pushpender Gupta
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Complete Resolution ◽  
Inferior Vena ◽  
Outpatient Surgery ◽  
Valsalva Maneuver ◽  
Vena Cava ◽  
Renal Vasculature ◽  
Ct Angiogram ◽  
Unenhanced Computed Tomography

A 54-year-old male presented to the outpatient surgery clinic with chronic intermittent right inguinal pain. An unenhanced computed tomography (CT) scan during Valsalve maneuver was performed, which demonstrated aortoiliac narrowing. Kinking of the duodenum and renal vasculature, and flattening of the inferior vena cava and iliac vasculature were also noted. A CT angiogram was subsequently performed without Valsalva maneuver which demonstrated complete resolution of the vascular and enteric findings. The case demonstrates that transient aortoiliac narrowing can also occur during voluntary Valsalva maneuver. Awareness of this entity is important so that patients can be reassured about the transient physiologic nature of these findings.

scholarly journals Clinical Insight into the Precaval Right Renal Artery: A Multidetector Row Computed Tomography Angiographic Study

ISRN Anatomy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Shubha Srivastava ◽  
Indra Kumar ◽  
C. S. Ramesh Babu ◽  
K. K. Gupta ◽  
O. P. Gupta
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Minimally Invasive ◽  
Renal Artery ◽  
Inferior Vena ◽  
Vena Cava ◽  
Multidetector Row Computed Tomography ◽  
Renal Vasculature ◽  
Multidetector Row ◽  
The Right

Variations of course and number of renal vessels are not so uncommon and their knowledge is important for planning of minimally invasive renal surgeries. The earlier literature reports a prevalence of precaval right renal artery between 0.8% and 5%. Normally, the right renal artery passes posterior to the inferior vena cava, but it can also be precaval where it passes anterior to inferior vena cava. The multidetector row contrast enhanced computed tomography angiography allows precise evaluation of renal vasculature. The aim of this retrospective study is to determine the prevalence of precaval right renal artery. Amongst 73 MDCT scans studied, we identified 4 cases of precaval right renal artery with the prevalence being 5.48%, more than what is reported in the earlier literature. We also report a single and dominant precaval right renal artery in one of the cases, which is a rare finding. On the basis of these results, we conclude that precaval right renal artery appears to be more common and so the knowledge of this variant holds a major clinical implication in preventing misinterpretation of radiological images and proper planning of interventional procedures and minimally invasive surgeries.

Biometry of the infrarenal inferior vena cava measured by computed tomography

1992 ◽  
Vol 14 (3) ◽  
pp. 265-269 ◽  
Author(s):  
Ph Bonnichon ◽  
F Gaudard ◽  
B Lecam ◽  
J Shilder ◽  
D Pariente ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava

The Value of Preprocedure Computed Tomography for Planning Insertion of Inferior Vena Cava Filters

2010 ◽  
Vol 61 (4) ◽  
pp. 223-229 ◽  
Author(s):  
Jeffrey D. Jaskolka ◽  
Rachel P.W. Kwok ◽  
Sara H. Gray ◽  
Hamid R. Mojibian
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Reference Standards ◽  
Ivc Filter ◽  
Renal Veins ◽  
Lumbar Vertebral Body ◽  
The Mean

Purpose To determine if valuable information could be obtained from abdominal computed tomography (CT) performed before insertion of an inferior vena cava (IVC) filter. Materials and Methods A retrospective review was performed on IVC filter insertions with a CT performed before the procedure. Cavagram and CT were compared for renal vein and IVC anatomy, the diameter of the IVC, and the prevalence of iliocaval thrombus. Correlations were assessed among 3 reference standards for measuring the IVC at cavography. Results The mean IVC diameter was 23.0 mm on CT. On cavagram the mean IVC diameter was assessed by using 3 reference standards: 20.7 mm, with the catheter tip as a reference; 26.9 mm, with a radiopaque ruler; and 23.4 mm, by using a lumbar vertebral body. There was good correlation among the 3 measures of IVC diameter (Pearson's r = 0.75, P < .0001) but moderate correlation with CT (r = 0.36–0.56, P < .001). The sensitivity of cavagram for detecting retroaortic and circumaortic renal veins was 40% and 0%, respectively. Nineteen accessory renal veins (12.8%) were not seen by cavagram. Thirteen patients (8.8%) had iliocaval thrombus on cavagram, of which 12 (92.3%) were not previously detected by CT. Conclusions CT is more sensitive than cavagram for detection of renal vein variants and the level of the lowest renal vein. Therefore, if available, the CT should be reviewed before placement of an IVC filter to optimize positioning. Cavagram remains the criterion standard for detection of iliocaval thrombosis and is necessary before IVC filter insertion.

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