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PubMed1979

Effect of phlebography on 125I uptake test.

Increased 125I fibrinogen uptake counts were encountered in 30 of 55 limbs after a normal ascending phelbogram. In most cases, the abnormal 125I fibrinogen uptake test occurred within 72 hr after phlebography, and the elevated counts were most frequently seen around the ankle, with contiguous involvement of the calf seen less often. Inly three patients with positive counts subsequently became symptomatic and were treated for deep venous thrombosis. The presence of deep venous thrombosis was confirmed by repeat ascending phlebography in two of these cases. Ascending phlebography was not performed on the other positive postphlebographic fibrinogen uptake test limbs.

Fibrinogen↗
PubMed1976

[The place of adrenal angiography (phlebography and arteriography) in the diagnostic stepwise program in arterial hypertension].

Arteriographical and phlebographical methods are distinctly suited for the diagnostics of the adrenal glands in the stop program of the combat against hypertension. Hypervascular tumours of the adrenal medulla, especially phaeochromocytomata may be established arteriographically relatively certainly. Avascular processes of the adrenal cortex, however, are better to be diagnosed by the selective phlebography of the adrenal glands. The phlebography is also suited for the planimetric determination of the size. The following uncorrected normal values were established: on the left m1 = 10.58 +/- 1.17 cm2, on the right m2 = 6.95 +/- 1.39 cm2. The mean value of normal couples of adrenal glands is M = 18.17 +/- 1.96 cm2. The left adrenal gland is statistically significantly larger than the right one (p greater than 0.001). In 214 patients altogether 44 selective arteriographies and 276 selective phlebographies of the adrenal glands were performed. As angiographical basis examination of all patients was at first performed an abdominal aortography or an angiography of the kidneys. The phlebographical diagnostics was successful on the left in 98.7% and on the right in 90.4% of the cases. 72 patients had pathological processes of the adrenal glands, out of them 20 times a solitary adenoma of the adrenal glands was present. 38 patients had a one- or double-sided hyperplasia, and 4 patients had a phaeochromocytoma. In 10 other cases more infrequent changes were found.

Adenoma↗
PubMedDate not supplied

[Diagnostic validity of radionuclide phlebography in the detection of clinically occult deep venous thrombosis in patients with thromboembolism].

Diagnostic reliability of radionuclide phlebography (RNP) compared to contrast phlebography in the detection of deep veins' thrombosis (DVT) in patients with confirmed thromboembolism of the lungs (TEL) was evaluated. RNP. These findings were compared to contrast phlebography (CP), performed in the group of 25 patients in whom TEL was confirmed clinically, radiologically, scintigraphically and biochemically, but without clinical signs and symptoms of DVT. In 15 patients where RNP revealed unilateral DVT, CP finding was confirmed in all: in 6 (40%) on the left, and in 9 (60%) on the right side. In 10 patients with bilateral signs of DVT observed by scintigraphy, DVT finding was confirmed in 7 (70%), while in 3 (30%) patients, scintigraphic signs of DVT were falsely positive. In the segments of deep venous system, specificity of RNP in the detection of DVT in the lower leg was 60%, sensitivity was 100%, accuracy was 64% with 62% falsely positive findings. In the upper legs specificity was 79%, sensitivity was 100%, and accuracy was 86% with 24% falsely positive findings, while in the pelvis specificity was 87%, sensitivity was 100%, accuracy was 83% with 14% falsely positive findings.

Humans↗
PubMed1975

[Role of phlebography in surgery of recurrent varicose veins of the lower limbs].

It is believed by the investigators of recurrent venous varicosity of lower limbs that phlebography aids to detect errors of the performed operative procedure and to reveal what caused the recurrence. The authors' experience comprise 48 distal, ascending, vertical phlebographies, and 47 pelvic and retrograde femoral ones in 60 patients, both explorations being utilized for 28 lower limbs. Distal phlebography in 44 of 48 examined patients indicated insufficiency of perforated veins that caused the recurrent crural varices. It is considered that in surgical therapy for venous varicosity a due consideration should be given for both a liquidation of recognized errors of the preceding surgery and a correction of pathological changes in deep veins of the lower extremities.

Adolescent↗
PubMed1976

[Paralytic ileus in pheochromocytoma. Possible correlation with an attempt at adrenal phlebography].

Following adrenal phlebography, obstruction of the large bowel associated with adrenergic crisis was observed in a 60 year old patient with pheochromocytoma. As in other published cases of ileus associated with pheochromocytoma, high urinary catecholamine concentrations were found in our patient and the tumor resected at surgery was large. As phlebography immediately preceded the onset of ileus and hypertensive crisis, it is postulated that angiography led to massive secretion of catecholamines, which caused the hypertensive crisis as well as the ileus. The possible mechanisms by which phlebography may lead to adrenergic crisis are discussed. It is concluded that in suspected pheochromocytoma all angiographic examinations should be carried out under simultaneous treatment with alpha-blocking agents.

Adrenal Glands↗
PubMed1992

[Prospective study of echography versus phlebography in the detection of sural venous thrombosis].

Among all noninvasive techniques, high-resolution ultrasonography used alone has rarely been used for the diagnosis of thrombosis in the calf. Nineteen patients with suspected AVT were examined with ultrasonography and phlebography during 4 months. For each patient, a sonogram and a phlebogram were taken within less than 24 hours and interpreted independently. The sonographic exploration with a high-resolution (5 MHz) transducer covers all deep trunks and muscular veins (soleus or gastrocnemius muscles). The positivity criterion is the persistence of a hypoechogenic endoluminal image under moderate compression. According to the phlebographic data, 65% of the patients present with thrombosis. Ultrasonography has a sensitivity of 95% and a specificity of 99% for the study of the deep trunks. Ultrasonography screens more thromboses than phlebography (23 cases versus 17). On a whole, ultrasonography seems to be more sensitive than phlebography for the diagnosis of recent sural thrombosis.

Acute Disease↗
PubMed1992

Comparison of descending phlebography with quantitative photoplethysmography, air plethysmography, and duplex quantitative valve closure time in assessing deep venous reflux.

To assess the role of noninvasive tests--quantitative photoplethysmography, air plethysmography, and quantitative duplex scanning, we compared a group of normal (group N, eight limbs) volunteers to patients with severe chronic venous insufficiency who were stratified according to the degree of reflux seen on the current "gold standard," descending phlebography. Group M (10 limbs) had mild (grades 0 to 2) reflux, and group S (10 limbs) had severe (grades 3 to 4) reflux as determined by phlebography. Quantitative photoplethysmography could identify normal from abnormal limbs but could not distinguish the severity of reflux. Air plethysmography was used to calculate venous filling index, ejection fraction, and residual volume fraction. Ejection fraction was the same in all groups. Venous filling index could not significantly distinguish the degree of reflux (group M vs group S) but increased as reflux increased. Residual volume fraction was considerably higher in group S. Quantitative duplex valve closure time was measured in the superficial femoral and popliteal veins, with the values added together in each limb to give a total valve closure time (TVCT). A TVCT value greater than or equal to 4 seconds correlated best with severe phlebographic reflux, with a sensitivity of 90%, a specificity of 94%, and an accuracy of 93%. This value was confirmed as the best test for venous reflux by receiver operating characteristic curve analysis. Thus in the evaluation of patients with severe chronic venous insufficiency who are candidates for phlebography and surgery, quantitative duplex measurement of TVCT gives the best noninvasive assessment of the severity of deep venous reflux.

Adult↗
PubMed1992

[The post-thrombotic syndrome. Description and comparison of diagnostic methods: clinical examination, venous return time, phlebography and ultrasonography].

Thirty-one patients with deep vein thrombosis (DVT) confirmed by phlebography 5-11 years previously were examined for the post-thrombotic syndrome (PTS). Where all of the patients were concerned, the examination included crossing-off of their symptoms of PTS on a special chart and clinical examination carried out by four doctors independently of one another, for 29 patients also determination of the venous return time by strain gauge pletysmography and for 29 patients also secondary phlebography (SF) and B-method ultrasonic scanning (UL). The degree of severity of PTS was determined by means of a scoring value which was calculated on the bases of four observers assessment of the clinical symptoms and findings. Significant differences were found for the clinical scores for legs with and without previous DVT, which shows that the method is of value despite a not inconsiderable interobserver variation. In the form employed here, pletysmography was found unsuitable for quantitating of PTS. In 60% of the patients, agreement was present between the clinical assessment, SF and UL. The necessity of agreement both as regards the diagnostic clinical criteria and as a measure for the degree of severity of PTS is emphasized. UL is recommended as a screening investigation for changes after DVT. Phlebography is only considered to be indicated in cases where detailed knowledge of the anatomical conditions is desired e.g. prior to venous surgery.

Adult↗
PubMed1992

[Color-coded duplex ultrasonography compared to phlebography in deep leg and pelvic vein thrombosis].

Between March 1990 and March 1991, in a prospective study, 100 patients (53 men, 47 women, median age 61.5 years) with suspected deep venous thrombosis of the lower extremities, colour duplex ultrasonography (CDU) (Ultramark 9, ATL) were investigated using the slow-flow technique. The CDU findings obtained for the external iliac vein (distal segment), the common femoral, the superficial femoral and popliteal veins, together with those of the veins of the lower extremity, were compared with the results of phlebography, which is considered to be the gold standard for this type of investigation. The sensitivity/specificity of CDU in diagnosing deep venous thrombosis was, from proximal to distal: 95.4%/100%, 100%/99%, 96.8%/97.1%, 98.5%/95.5% and 96.3%/98%. Fibrinolytic therapy (ultra high-dose short-term therapy: n = 16 patients; conventional fibrinolytic therapy: n = 4 patients) was indicated in 20 patients. In this group of patients identical results were obtained with CDU and ascending phlebography. Our experience shows CDU to be a supplementary diagnostic procedure to real-time B mode ultrasonic imaging in the establishment of the primary diagnosis, and to be superior to it in the follow-up evaluation of the results of fibrinolytic treatment. Both in the establishment of the primary diagnosis and follow-up of thrombosis of the deep leg and pelvic veins, CDU is the equal of phlebography. The advantage of the latter is in the documentation of the entire venous system and staging of post-thrombotic syndrome.

Adult↗
PubMed1991

[Percutaneous ascending phlebography in acute thrombosis of the deep veins of the lower limbs].

The author describes a method for percutaneous ascending phlebography of the lower limbs which was conducted in 258 patients: he performed 315 ascending phlebographies (the examination was unilateral in 201 and bilateral in 57 patients). Nonocclusive and occlusive venous thromboses of the deep veins of the lower limbs were revealed in 225 patients. In 23% of the examined patients abnormalities were not found in the veins of the lower limbs, in 10 cases the examination was not carried out to the end for various reasons. The method allows the location of the lesion and the character of phlebothrombosis to be determined, its important merit consists in the possibility of contrast study of the sural veins which were demonstrated in 93.5% of patients with nonocclusive thromboses and in the absence of changes in the veins. Percutaneous ascending phlebography of the lower limbs is a highly effective, mildly injurious, and relatively safe method of examination, which meets all conditions of emergency angiography and provides the possibility of repeating the examination through the same approach.

Adult↗
PubMed1990

[Can ultrasonic scanning replace phlebography in the diagnosis of deep thrombophlebitis of the leg?].

Until recently, phlebography with contrast agents has been the standard method for demonstration of deep venous thrombosis in the lower limb (DVT). In recent years, however, this has been replaced to an increasing extent by ultrasonic scanning. In contrast to radiographic examination, this method does not require injection of a contrast agent and it does not employ ionizing irradiation. The principle of ultrasonic scanning is that a normal vein may be compressed flat by means of slight pressure from the transducer whereas a vein filled with thrombi cannot be compressed. Ultrasonic examination is not (yet?) of diagnostic value in the leg but, more centrally, it is of the same diagnostic value as radiographic examination. It is suggested that ultrasonic scanning can replace phlebography in patients with their first DVT. If this gives a negative result, it may possibly be supplemented by phlebography of the veins of the leg.

Evaluation Studies as Topic↗
PubMed1989

[Evaluation of the value of testicular phlebography].

The authors use testicular phlebography since 1979; they examined so far 72 patients (62 children and 10 adults). Phlebography was indicated in 54 patients with varicocele and in 18 children with an unpalpable testicle. The authors evaluate the method with regard to the surgical procedure in the treatment of varicocele. In unpalpable testicles phlebography proves in some cases useful in the differential diagnosis. The authors evaluate the importance of the examination. The new findings regarding anatomical and functional aspects are, no doubt, valuable. On the other hand, the authors draw attention to the complicated examination (in particular in children) to the invasive character of the examination and the irradiation load.

Adolescent↗
PubMed1989

[Transpopliteal phlebography in the diagnosis of chronic diseases of the veins of the lower extremities].

From experience in 98 studies the authors claim that transpopliteal phlebography yields information on the condition of the popliteal and the tibial veins and the ostial valve of the small saphenous vein in retrograde, and on the condition of the femoral vein in antegrade administration of the radiocontrast medium. It is indicated for patients suffering from varicosity in ectasia of the popliteal and tibial veins, as well as when the results of clinical tests for competence of the valves of the small saphenous vein are doubtful. The absence of visualization of the femoral vein in ascending distal or retrograde femoral phlebography in patients with congenital venous dysplasia or with phlebothrombosis sequelae is an indication for antegrade transpopliteal phlebography.

Chronic Disease↗
PubMed1989

[Pitfalls in phlebography].

Despite the progress in functional investigation procedures, phlebography remains the standard test in venous disease of the lower extremities. The development of better quality contrast media has significantly improved patients tolerance. After a review of the regular, routine procedure, the authors stress the technic's pitfalls. Uncomplicated pitfalls are air bubbles, Venturi's effect, venous malformations, and superimposed venous axes or gases. This type of problems is easily circumvented. Flow images caused by confluent axes of high-flow veins (internal iliac veins, renal veins) or layer courants (gutter effect) are presented as a reminder. Compression images are often more treacherous: related to normal veins: compression of left iliac vein by aortic junction; of inferior vena cava by enlarged aorta or by osteophyte; tourniquet too low, iliac vein compressed by a dilated bladder; or compression due to intramuscular hematoma,... related to pathological veins: to be mentioned are bridle-caused obstruction of the popliteal vein (Klippel-Trénaunay syndrome), and retroperitoneal fibrosis. Although the present description of phlebography-related pitfalls is neither new, nor exhaustive, it should be reconsidered, as phlebography of the lower limbs, while being currently better tolerated, is still an update technic that needs to be rendered more reliable.

Constriction↗
PubMed1989

[Role of intraoperative phlebography in the therapeutic approach of varicocele].

Personal experience of intraoperative anterograde phlebography of the internal spermatic vein is reported. The use of this technique is suggested for controlling the result of internal spermatic vein ligature in cases of type I varicocele according to Coolsaet, diagnosed by preoperative retrograde phlebography. Early data make it possible to conclude that intraoperative anterograde phlebography is a valuable aid in reducing the frequency of recurrences.

Adolescent↗
PubMed1989

[Digital subtraction angiography in lower extremity phlebography].

DSA was applied to the lower extremity phlebography on 21 cases (36 legs). The patient lay in the supine position and a tourniquet was placed around the ankle. Forty ml of contrast medium, diluted to 25% of the original concentration with normal saline, was injected into the dorsal vein of the foot. The anterior tibial vein, posterior tibial vein, peroneal vein and muscular vein of the calf were identified in 24 (63.2%), 36 (94.7%), 37 (97.4%) and 7 legs (18.4%), respectively. The poor opacification of the anterior tibial vein was attributed partly to the compression effect of the tourniquet. The abnormal findings were deep vein thrombosis (5 legs), reflux from the deep to the superficial vein (14 legs) and irregularity of the venous wall (16 legs). The superficial varicose veins were not demonstrated in DSA phlebography. The examination was comfortable because the patient position was supine and the dilute contrast medium caused no burning sensation. We believe that DSA phlebography is a safe and useful method for diagnosing the deep venous system disorders.

Adult↗
PubMed1988

[Phlebography of the upper extremity--examination technic, indications and results].

Three radiological methods of examination can be used in phlebography of the upper extremity: screening (fluoroscopy) combined with on-target x-ray film examination; sheet film angiography; digital subtraction phlebography (DSP). Phlebography of the veins of the forearm performed preoperatively for selecting suitable veins for a dialysis shunt, should be done by screening with on-target x-ray film takes in several planes. DSP should be given preference if there is suspicion of thrombosis of the shoulder veins and the superior vena cava.

Arm↗