Douglas S. Katz, MD, Faculty Attending Radiologist
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Until now, radiologists have searched for deep venous clots in the legs with ultrasound testing of the legs. CTVPA facilitates a thorough examination of areas not routinely searched by ultrasound of the legs...including the central veins of the abdomen and pelvis, and the deep leg veins below the knee.
 lood clot, whether stationary or traveling stealthily through the circulatory system, can cause a brain or heart attack when it lodges in a vessel or in the lung, preventing the free flow of blood to the brain and heart. Vascular surgeons have long depended on radiological imaging to help detect clot. Once identified, certain patients are surgically implanted with a caval filter, which helps to "catch" clots and prevent them from causing life-threatening circulatory problems.
Now at Winthrop, Faculty Attending Radiologist Douglas S. Katz, MD has introduced a new scan - the CTVPA - which allows more accurate imaging of patients with suspected pulmonary (lung) emboli - traveling clots - or deep venous thrombosis (stationary clot). The CTVPA will be utilized in patients for whom the first line tests, such as the nuclear lung scan, prove inconclusive.
This film, prepared by Douglas S. Katz, MD, Attending, Radiology, shows what he sees when searching for clot in a 79-year-old male patient with right calf swelling. The arrow points to a filter, previously placed for deep venous thrombosis.
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Winthrop is believed to be the only Long Island hospital to provide CTVPA, which is also available at The New York Hospital in New York City, and in upstate Buffalo, at the Roswell Park Cancer Institute. Dr. Katz and Winthrop Radiology Resident, Rakesh Shah, MD, developed CTVPA, in conjunction with co-investigators from the Roswell Park Cancer Institute. Dr. Katz has successfully utilized the technique at Winthrop since mid-1997, and had completed more than 100 cases by October, l998.
CTVPA is extremely helpful in the analysis of the pulmonary vessels and the deep veins of the legs. Until now, radiologists have searched for deep venous clots in the legs with ultrasound testing of the legs. CTVPA also facilitates a thorough examination of areas not routinely searched by ultrasound of the legs, including the central veins of the abdomen and pelvis, and the deep leg veins below the knee. The investigative team modified the usual CT lung scan technique for suspected pulmonary artery clots by obtaining selected additional images of the abdomen, pelvis, and legs, in an examination for deep vein blood clots, about three minutes after the injection of intravenous dye for CT images of the chest. Patients need no additional intravenous dye above the normal amount. As the procedure involves only about 12-15 additional images, there is relatively minimal additional radiation and no additional cost.
Once radiologists have identified clot in the lungs, alone or in combination with clots of the veins of the abdomen, pelvis, or legs, immediate, appropriate treatment can begin - which could include hospitalization, the administration of blood thinners, and other interventions.
For further information on the CTVPA scan, call Dr. Douglas Katz at 516/663-2374.
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