A narrative review of 3D-venography for the assessment of IVC filter-related thrombosis.

OBJECTIVES This narrative review aims to critically appraise the technical advantages, clinical applications, and limitations of 3D-Venography specifically in the context of IVCFT, and to compare its diagnostic performance with traditional and emerging imaging modalities.

KEY FINDINGS A comprehensive literature search was conducted in PubMed, Embase, and Web of Science (January 2010-December 2024) using keywords: ("3D-Venography" OR "three-dimensional venography") AND ("inferior vena cava filter thrombosis" OR "IVCFT") AND ("diagnosis" OR "imaging"). 3D-Venography technology, characterized by its capability to comprehensively assess both intra- and extra-vascular lesions and perform real-time vascular lumen data measurement, has emerged as a critical supplement to traditional digital subtraction angiography (DSA). 3D-venography provides multi-angle anatomical visualization and real-time hemodynamic assessment of IVCFT, addressing limitations of 2D-digital subtraction angiography (2D-DSA) (e.g., projection overlap) and non-invasive modalities (CTA/MRA, e.g., lack of real-time data). However, it is associated with higher radiation exposure than 2D-DSA and requires specialized equipment.

CONCLUSIONS Based on current available evidence, 3D-venography shows potential for IVCFT assessment, particularly in guiding interventional procedures, though its long-term clinical benefits require further validation by large-scale comparative studies. Its widespread adoption is limited by gaps in comparative outcome data, radiation concerns, and cost. Future research should prioritize dose optimization and large-scale diagnostic accuracy studies.

IMPLICATIONS FOR PRACTICE Clinicians should prioritize 3D-Venography as a key imaging tool in the evaluation of IVCFT, leveraging its advantages in multi-modal, real-time, and high-resolution vascular visualization to potentially optimize treatment planning (e.g., filter placement/removal) and postoperative monitoring, with such benefits yet to be confirmed by prospective outcome studies. Further integration of 3D-Venography with emerging non-invasive techniques (e.g., CTA, MRA) may enhance diagnostic accuracy and guide personalized therapeutic strategies.