Inferior vena cavography after partial caval occlusion

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Abstract
Partial surgical occlusion of the inferior vena cava, either by plication or caval clip, has been undertaken in 39 patients to prevent pulmonary embolism. Post-operative cavograms are presented and the radiological signs of patency and obstruction of the larger veins are described. In approximately four-fifths of the patients the cava has remained patent, though narrowed. It is shown that obstruction of the large veins may be due to internal thrombosis or extrinsic pressure. The radiological appearance of intravenous thrombus is demonstrated. The extensive collateral circulation which accompanies caval obstruction is illustrated and changes in the venographic features over a period of time are described. Brief mention is made of the effect of respiration on the radiographic appearances during cavography. The effectiveness of the operation of partial caval occlusion, whether by plication or caval clip, is shown. There is little doubt that these procedures achieve their object in reducing the caval diameter and lessening the likelihood of pulmonary embolism, with less circulatory disturbance than occurs after caval ligation.