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[Mercury gauge plethysmography. Sensitivity and specificity compared with standard phlebography (author's transl)].

Mercury strain gauge plethysmography with programme and ECG synchronous venous occlusion was tested in 14 normal subjects (28 lower limbs). The results obtained in the case of recent deep venous thrombosis of the lower limbs were compared with those of phlebography ni 39 patients: 26 proximal thromboses and 15 calf thromboses. Interpretation of the results must take into account the strict conditions under which the plethysmography was carried out: position of the subject and especially of the lower limbs and the technical characteristics of the apparatus used. Specificity was 96.4% for the group of normal subjects. Sensitivity calculated for all the cases of venous thrombosis studied was 97.5% whilst it was 100% for proximal thromboses (femoral and iliac).

Acute Disease↗

[The detection of deep venous thrombosis by fibrinogen labelled with iodine 125. Specificity and sensibility in comparison with standard phlebography (author's transl)].

During the last 6 years, more than 4,000 tests using 125I fibrinogen have been performed on orthopedic and traumatic patients who were undergoing a thromboembolic treatment by means of subcutaneous heparin. The high accuracy of this method has been confirmed using phlebography. This test still remains a simple, faithful, and non traumatic diagnosis tool in the early detection of thrombosis of the limbs of patients undergoing traumatologic and orthopedic surgery. Moreover, the labeled fibrinogen test is useful in the determination of the efficiency of antithrombotic preventive therapy.

Diagnosis, Differential↗

[Phlebography of the cavernous and intercavernous sinuses; an investigation complementary to CT detecting intrasellar space-occupying lesions].

The technique of peri-hypophyseal phlebography is briefly described and the theoretical bases that inspire its utilizations and indications are pointed out. On the basis of 20 preliminary cases, the main applications of this investigation are illustrated, with a particular attention concerning the early diagnosis of lesions too small or too dishomogeneous to be detected with certainly on CT (i.e. intrapituitary microadenomas smaller than 5 mm; associated intrasellar lesions as empty sella + pituitary tumor).

Adenoma↗

[Value of phlebography in the diagnosis of edema of the leg].

In the diagnosis of leg edema, important phlebographic procedures are explained in terms of their technique and the information they provide. Ascending phlebography is the most important procedure for diagnosis of phlebothromboses, post-thrombotic syndromes, occlusions of the deep veins of other genesis, perforans insufficiency as well as vessel malformations. Additional administrations of selective contrast medium, intraoperative techniques as well as transosseous contrast medium administration are mentioned as rare supplementary methods. Peripheral open measurement of venous pressure constitutes an important additional documentation of vein function. The limits of the information provided are explained with reference to the normal phlebogram as well as to findings of venous reflux disturbances in the region of the deep veins, especially in acute thrombosis and occlusion of deep veins.

Humans↗

Diagnosis of deep venous thrombosis in obstetrics and gynecology by impedance phlebography.

The accurate diagnosis of deep venous thrombosis is fundamental in reducing the morbidity and mortality from thromboembolism in obstetrics and gynecology. This is the first report of the use of a noninvasive diagnostic technique, occlusive cuff impedance phlebography (IPG), on an obstetric and gynecologic service. One hundred sixteen patients were examined by IPG with an overall diagnostic accuracy of 95.6% (sensitivity, 87.5%; specificity, 93.8%). Ninety-one patients had symptoms suggestive of deep venous thrombosis, but this diagnosis was confirmed in only 26.3%. The use of IPG to screen high-risk patients prospectively and evaluate patients with pulmonary emboli is discussed. IPG is ideally suited as a diagnostic method in obstetrics and gynecology because it is accurate, noninvasive, and nonradiologic, and it may be performed at the patient's bedside.

Adolescent↗

[Phlebography, a safe and simple method in the diagnosis of renal agenesia/dysgenesia (author's transl)].

It is not possible to completely exclude the possibility of errors in clinical and urographic suspicion of renal agenesia/dysgenesia, using sonography, computerised tomography or arteriography. Phlebography yields the most unequivocal findings; in fact, this method is particularly applicable in case of desired withdrawal of venous blood for the purpose of determination of renin. Attention must be paid to variation in venous drainage on both sides, especially, however, on the left side. Dysplastic pelvic kidneys are probably detected most safely by means of computerised tomography.

Adult↗

Leg scanning with radioisotope-labeled fibrinogen in patients undergoing hip surgery. Comparison with contrast phlebography and lung scans.

To establish whether radioisotope-labeled fibrinogen leg scanning is of value in the context of hip surgery, we prospectively studied 21 consecutive patients undergoing either total hip replacement (14) or open repair of a hip fracture (seven) with leg scans, contrast phlebography, and ventilation and perfusion lung scans. We found that in eight patients (38%), venous thromboembolism developed postoperatively. Agreement between phlebographic and leg scanning results was excellent. In no patient was venous thrombosis limited to the thigh on the operated-on side, a vital consideration in application of fibrinogen leg scanning to this patient population. Two patients had lung scan changes indicative of embolism; both had thrombi extending into thigh veins. Leg scanning with radioisotope-labeled fibrinogen appears to be a useful method for monitoring patients undergoing hip surgery, if the upper three counting points on the operated-on side are excluded.

Adult↗

[Budd Chiari syndrome in 3 brothers. Diagnosis in 2 by phlebography].

Three patients with Budd-Chiari Syndrome, belonging to the same family are presented. The diagnosis was made through phlebography in 2 cases, and by atuopsy in the other one. There is not report in the medical literature of familiar appearance of this syndrome. The importance of roentgenographic studies in order to make the diagnosis is emphasized. Genetic studies were not performed and its contribution to develop such vascular changes in unknown. Some considerations about the environment influence are discussed.

Budd-Chiari Syndrome↗

[Phlebography of the internal spermatic vein (author's transl)].

Phlebography of the internal spermatic vein in male patients suffering from infertility is a diagnostic procedure of low risk. In 432 patients examined for this condition, varicoceles were found, 67.5% of which occurred on the left, 13.8% on the right side. This fairly high number of varicoceles on the right side was surprising. It may be due to the technique, which requires standardisation and an experienced examiner in order to achieve a high rate of success. The possibility of a connection between unsatisfactory examination technique and unsatisfactory therapeutic results is discussed.

Humans↗

[Phlebography in children with varicocele (author's transl)].

The condition of varicocele is rare in childhood. Usually it is not observed before puberty, and can cause infertility if not operated upon in time. With the usual examination of the children in supine position the varicocele can be overlooked. The primary idiopathic type with insufficiency of the spermatic vein is distinguished from the rare secondary symptomatic form, mainly caused by renal tumours. A renal mass should be excluded by an intravenous urography in every case. The percutaneous selective phlebography of the spermatic vein--results in two boys with primary idiopathic varicocele are described--is indicated, if clinical symptoms are still existing despite high ligature of the vein. Further open branches of the spermatic vein and collateral circulation can be shown by this method, the way and type of the second operation better planned, and the patients saved from the threatening infertility.

Adolescent↗

[Selective external vein phlebography].

The authors describe a simple technique for opacification selectively of the external saphenous venous system. The principal features of the test are: direct puncture of the external saphenous system, and dynamic study of the Xray image. Selective phlebography of the external saphenous facilitates the choice between sclerosant and surgical treatment as well as the execution of the latter.

Humans↗

[Diagnosis of venous circulation disorders in the cervical portion of the spine and spinal cord using selective phlebography].

Selective phlebography of the major branches of the vena cava superior, supplemented, if necessary, by selective catheterization of the spinal vein, was employed to study the disorders in the cervical section of the spine and cord. Twenty-five patients with myelopathies of obscure origin were examined. The main symptoms were stenoses and atresias of the orifices of the internal jugular veins and compression and stenoses of the brachiocephalic trunks. The possibility of a reverse venous blood stream from the nonspinal veins to the epidural ones and backward was confirmed. Therefore, a disorder of the venous outflow from the spinal channel, on the one hand, and intensification of the venous blood inflow, on the other, may develop under certain conditions, resulting in intrachannel hypertension. Eight patients with pathologic changes in the veins (decompressions and angiolysis) were operated on.

Adult↗

[Phlebography of the upper extremity (author's transl)].

Various modifications of phlebography of the upper extremity are described. Evaluation of 95 pathological phlebograms proves the importance of phlebographic early diagnosis in the Paget-Schrötter syndrome, in traumatic and iatrogenic vein lesions. A phlebographic delimitation of obstructed drainage, caused by tumors, from scarred stenosing is only seldom possible.

Arm↗

[A comparison of sonography and phlebography in the diagnosis of deep venous thrombosis of the lower extremities].

In recent years, non-invasive sonographic techniques [real-time ultrasound (US), duplex ultrasonography (DU) and color-coded duplex sonography (CCDS)] have increased in importance for the diagnosis of lower extremity deep venous thrombosis. To ascertain the accuracy and limitations of these techniques prospectively, various studies have been performed to compare sonography with venography. This review deals with basic methodologic considerations when two imaging methods are compared and describes the features of deep venous thrombosis seen on US, DU and CCDS. Reports comparing sonography and phlebography for the diagnosis of deep venous thrombosis are presented and discussed. The advantages and limitations of US, DU and CCDS for the diagnosis of iliac, femoral, popliteal and infrapopliteal venous thrombosis are compared with those of venography, and controversial areas are touched on.

Humans↗

[Brachial edema after treatment of mammary carcinoma: significance of phlebography (author's transl)].

The frequency of thromboses or of obstacles to the venous flow in brachial or axillary regions has been examined by a phlebographic survey of 102 patients who were treated surgically and radiotherapeutically because of cancers of the breast. Thromboses or venous obstruction were found in the 86 patients with brachial edema. Ten of the patients (12%) with brachial edema had thromboses. Further 15 suffered from an obstruction to the venous flow. The results are discussed in detail, and compared with the rather contradictory data in literature. As a consequence of this study an indication for brachial phlebography would be justified on a larger scale with patients having been treated surgically because of mammary carcinoma.

Arm↗

[The muscular pump of the calf. Video-phlebography and simultaneous EMG].

Gastrocnemical insufficiency is a common syndrome (in modern society mainly affecting young females who have been taking the pill for several years). Often it is the starting point for superficial varicosis. The clinical diagnosis is easy, provided the doctor is informed of its symptoms. Phlebography or Duplex scan are compulsory, deciding surgical treatment. Varicose muscular veins have two different causes: avalvulation at the popliteal vein or compression by the Post. Tib. nerve. Persistent pain, deterioration of the superficial network or neuromyositis are the main reasons for deciding upon surgical treatment. The results are gratifying and lasting.

Adult↗

Value of venous pressure and phlebography in detecting deep vein thrombosis after major surgery and in primary venous disease.

A total of 60 patients from high risk group for deep vein thrombosis, which included the patients after major surgery and patients of primary venous diseases, were studied. Peripheral venous pressure measurement performed on 42 cases, detected deep vein abnormality in 6 patients (14.3%) only out of which 2 patients were designated as cases of deep vein thrombosis and 4 of chronic venous stasis syndrome. But phlebography detected deep vein thrombosis in 28 cases (46.6%) and other deep vein abnormalities in rest of the cases.

Adult↗