Quantitative 2-Dimensionsal Digital Subtraction Venography for Venous Interventions: Validation in Phantom and In Vivo Porcine Models

J Vasc Interv Radiol. 2024 Sep;35(9):1367-1376.e2. doi: 10.1016/j.jvir.2024.06.008. Epub 2024 Jun 19.

Abstract

Purpose: To determine the feasibility of using a 2-dimensional quantitative digital subtraction venography (qDSV) technique that employs a temporally modulated contrast medium injection to quantify blood velocity in phantom, normal, and stenotic porcine iliac vein models.

Materials and methods: Blood velocity was calculated using qDSV following temporally modulated pulsed injections of iodinated contrast medium and compared with Doppler ultrasound (US) measurements (phantom, in-line sensor; in vivo, diagnostic linear probe). Phantom evaluation was performed in a compliant polyethylene tube phantom with simulated venous flow. In vivo evaluation of qDSV was performed in normal (n = 7) and stenotic (n = 3) iliac vein models. Stenoses were created using endovenous radiofrequency ablation, and blood velocities were determined at baseline, after stenosis, after venoplasty, and after stent placement.

Results: In the phantom model, qDSV-calculated blood velocities (12-50 cm/s) had very strong correlations with US-measured velocities (13-51 cm/s) across a range of baseline blood velocities and injection protocols (slope, 1.01-1.13; R2 = 0.96-0.99). qDSV velocities were similar to US velocities regardless of injection method: (a) custom injector, (b) commercial injector, or (c) hand injection. In the normal in vivo model, qDSV-calculated velocities (5-18 cm/s) had strong correlation (slope, 1.22; R2 = 0.90) with US-measured velocities (3-20 cm/s). In the stenosis model, blood velocities at baseline, after stenosis, after venoplasty, and after stent placement were similar on qDSV and US at all time points.

Conclusions: Venous blood velocity was accurately quantified in a venous phantom and in vivo porcine models using qDSV. Intraprocedural changes in porcine iliac vein blood velocity were quantified with qDSV after creation of a stenosis and subsequently treating it with venoplasty and stent placement.

Publication types

  • Validation Study

MeSH terms

  • Angiography, Digital Subtraction*
  • Animals
  • Blood Flow Velocity
  • Constriction, Pathologic
  • Contrast Media / administration & dosage
  • Disease Models, Animal
  • Feasibility Studies*
  • Iliac Vein* / diagnostic imaging
  • Iliac Vein* / physiopathology
  • Phantoms, Imaging*
  • Phlebography*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Stents
  • Swine
  • Ultrasonography, Doppler

Substances

  • Contrast Media