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Chen CW, Tseng YH, Kao CC, Ngo YG, Lee CY, Yang TY, Lin YH, Huang YK. Venous Segmental Flow Changes after Superficial Venous Intervention Demonstrating by Quantitative Phase-Contrast Magnetic Resonance Analysis: Preliminary Data from a Longitudinal Cohort Study. J Pers Med 2022; 12:jpm12061000. [PMID: 35743784 PMCID: PMC9224938 DOI: 10.3390/jpm12061000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/11/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022] Open
Abstract
The effects of superficial venous intervention on hemodynamics can be quantified using two-dimensional phase-contrast magnetic resonance imaging (2D PC-MRI). Twelve patients received pre- and postintervention 2D PC-MRI analysis using quantitative hemodynamic parameters. Fifteen healthy volunteers served as controls. The 2D PC-MRI results of the target limbs (limbs scheduled for intervention for venous reflux) differed from those of the controls in terms of stroke volume (SV), forward flow volume (FFV), absolute stroke volume (ASV), and mean flux (MF) in all venous segments. The velocity time integral (VTI) and mean velocity (MV) of the popliteal vein (PV) segments were similar between the target limbs and controls preoperatively. After intervention, the target limbs exhibited an increase in VTI and MV in the femoral vein (FV) and PV segments. We compared the target and nontreated limbs of the individual patients preoperatively and postoperatively to minimalize individual bias. All QFlow parameter ratios in the FV segment increased after venous intervention (VTI, p = 0.025; MV, p = 0.024). In the PV segment, FFV and ASV increased significantly (p = 0.035 and 0.024, respectively). After interventions, the volume (FFV and ASV) of the PV segment and the efficiency (VTI and MV) of the FV segment significantly increased.
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Affiliation(s)
- Chien-Wei Chen
- Department of Diagnostic Radiology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
| | - Yuan-Hsi Tseng
- Department of Obstetrics and Gynecology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Chih-Chen Kao
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Hospital, MOHW, Chiayi 61363, Taiwan
| | - Yeh Giin Ngo
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Department of Obstetrics and Gynecology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Chung-Yuan Lee
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Department of Obstetrics and Gynecology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Teng-Yao Yang
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Cardiology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Yu-Hui Lin
- Cardiology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Yao-Kuang Huang
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Hospital, MOHW, Chiayi 61363, Taiwan
- Correspondence:
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Khan F, Sharma N, Ud Din M, Chetram R. Diagnostic and Therapeutic Challenges of Cerebral Venous Thrombosis in SARS-CoV-2 Infection: A Case Report and Review of Literature. Clin Pract 2021; 11:598-606. [PMID: 34563004 PMCID: PMC8482202 DOI: 10.3390/clinpract11030075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/17/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022] Open
Abstract
Headache, a common prodromal symptom of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, can also be a manifestation of cerebral venous thrombosis (CVT), secondary to COVID-19. CVT management continues to evolve, with direct oral anticoagulants (DOACs) emerging as an alternative to warfarin. A 44-year-old Asian female, with no past medical history, presented to the emergency room (ER) with complaints of nonproductive cough and left-sided headache. She denied a history of COVID-19 vaccination, and SARS-CoV-2 testing (with reverse transcriptase-polymerase chain reaction) was positive. Non-contrast computed tomography (CT) of the head revealed left transverse sinus hyperdensity, consistent with dense vein sign, and magnetic resonance venography (MRV) confirmed the presence of thrombus. The initial treatment included subcutaneous enoxaparin with headache resolution, and she was discharged on apixaban. Five weeks later, a non-contrast head CT showed resolution of the dense vein sign and recanalisation of left transverse sinus was seen on MRV. This report has highlighted the need for increased awareness of coagulopathy and thrombotic events, including cerebral venous thrombosis, in patients infected with SARS-CoV-2. Unremitting headache, in context of SARS-CoV-2 infection, should be evaluated with appropriate neurovascular imaging. Controlled studies are required to compare the safety and efficacy of DOACs with warfarin for management of cerebral venous thrombosis.
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Affiliation(s)
- Faisal Khan
- Neurology, College of Osteopathic Medicine, Sam Houston State University, Huntsville, TX 77340, USA
- Correspondence: ; Tel.: +713-234-7132; Fax: +281-249-5439
| | - Neha Sharma
- Neurology, Houston Medical Clerkship, Sugar Land, TX 77478, USA; (N.S.); (M.U.D.)
| | - Moin Ud Din
- Neurology, Houston Medical Clerkship, Sugar Land, TX 77478, USA; (N.S.); (M.U.D.)
| | - Ryan Chetram
- School of Medicine, Caribbean Medical University, 4797 Willemstad, Curaçao;
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