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PubMed1977

The importance of retrograde phlebography in the diagnosis of orbital lesions.

The authors describe a technique for retrograde phlebography of the orbit. A selection of the typical findings in 51 cases of orbital phlebography is presented. The diagnostic importance of the examination in cases of similar clinical symptoms has been stressed. This method is best suited to the investigation of cases of venous malformation, especially of the intra-orbital, peri-orbital and retro-orbital area. Side-effects and complications have been described. A comparative assessment against other competetive methods of investigation, like the computer tomography has been attempted.

Cavernous Sinus↗
PubMed1996

A prospective, parallel, double-blind comparison of iodixanol and iohexol in extremity phlebography.

RATIONALE AND OBJECTIVES: A two-center, prospective, double-blind study was conducted to compare the performance parameters (efficacy, safety, and injection-associated discomfort) of iohexol with those of the new, isosmolar contrast medium iodixanol in extremity phlebography. METHODS: Ninety-nine patients from two centers, for whom venography was clinically indicated, were blindly randomized into two groups, iohexol at 300 mg I/ml (IOH 300) or iodixanol at 270 mg I/ml (IOD-270). Patient vital signs and reports of adverse events were recorded for a minimum of 1 hr and monitored until the outcome was known. Any discomfort associated with the injection was also recorded. Laboratory measures included urinalysis, creatinine levels in serum and blood urea nitrogen. RESULTS: Both contrast media provided good or excellent visualization in nearly all patients (100% of patients in the IOD-270 group and 96% in the IOH-300 group). The incidence of adverse reactions was low in both groups (8.5% in the IOD-270 group and 10% in the IOH-300 group). Injection associated discomfort lasting less than 4 min occurred in nine patients, four in the IOD-270 group and five in the IOH-300 group. Although clinically relevant changes in vital signs occurred in more than half the patients, most were judged to be anxiety related. Review of laboratory data revealed no evidence of toxicity for either agent. There was no statistically significant difference between the two agents with regard to any of these observed parameters. CONCLUSION: The data support the conclusion that both IOD-270 and IOH-300 are safe and effective agents when used for adult phlebography and are associated with little injection-site discomfort.

Adult↗
PubMed1995

Immediate and delayed tolerance of iohexol and ioxaglate in lower limb phlebography: a double-blind comparative study in humans.

RATIONALE AND OBJECTIVES: We compared the tolerance and efficacy of iohexol-300, a nonionic low-osmolar monomer, with those of ioxaglate-320, an ionic low-osmolar dimer, in lower limb phlebography. METHODS: One hundred twenty inpatients were randomly divided into two groups in this double-blind comparative study. Two hundred milliliters of contrast medium (100 ml per leg) was injected intravenously. The immediate tolerance was classified as discomfort (i.e., sensation of warmth, pain, coldness related to the injection) and adverse events occurring up to 1 hr after administration. Delayed tolerance was followed up to 8 days after the examination. The main parameter was immediate adverse events. Image quality was assessed by a radiologist using a visual analog scale. RESULTS: The number of immediate adverse events was significantly higher in the ioxaglate group (p < .02). The more frequent events were digestive disorders and skin rashes; 13 of these events were reported in the ioxaglate group, but none were reported in the iohexol group (p < .001). The other parameters were not significantly different in the two groups. CONCLUSION: We found a similar efficacy and a better tolerance of iohexol-300 than ioxaglate-320 in lower limb phlebography.

Contrast Media↗
PubMed2001

Varicosis of the accessorial lateral saphenous vein: evidence of recirculation shown by pre-operative phlebography.

BACKGROUND: The incidence of varicosis of the anterior side branch of the long saphenous vein clinically ranges about 8 to 10% of descending venous decompensation, originating at the level of the thigh. Its incidence in women showing significant overweight is clearly pronounced. Mostly torturous and enlarged varicosed segments of the accessorial lateral saphenous vein can be seen clinically crossing the anterior middle of the thigh. The indications for surgical radical extirpation of the entire varicosed side branch depends from pain, phlebitic complications, peripheral venous dysfunction including cosmetic aspects. PATIENTS: In a clientele of 138 patients (females: 114, males: 24) the phlebographic demonstration of the entire recirculation pathways was performed prior to surgery. RESULTS: Ascending leg phlebography was found sufficient in 7.7% of cases only. Combined with varicography however, in further 90.7% of patients a clear demonstration of the upper and lower points of venous insufficiency was possible. The extent of functional disorders was calculated by additional peripheral venous pressure measurements. CONCLUSIONS: This clientele clearly shows that long-term reflux via the varicosed side branch increases the tendency of peripheral functional decompensation along the lower leg. Adequate surgical therapy depends from a clear demonstration of the varicosed veins being involved, and this can be realized by combined phlebography and varicography.

Female↗
PubMed1987

Orbital phlebography in patients with cluster headache.

Thirteen patients with cluster headache in an active stage were investigated with orbital phlebography. About 60% of the patients showed pathologic changes on the phlebograms, such as changes in the appearance of the superior ophthalmic vein. Five patients had pathologic changes on both sides and three patients on one side only. All patients with unilateral pathologic findings on orbital phlebography had the attacks on the same side. The phlebographic findings in these patients with cluster headache were very similar to those of patients with the Tolosa-Hunt syndrome. There is also some similarity in the symptoms in the two disorders. It has previously been suggested that the Tolosa-Hunt syndrome is caused by venous vasculitis, and the present findings to some extent support the idea that cluster headache may have the same etiology.

Adult↗
PubMed1975

[Results of post mortem thyroid gland phlebography (author's transl)].

The anatomic course and variation of the thyroid veins used for retrograde thyroid phlebography were studied in 70 post mortem thyroid phlebograms. Comparison with pathological and anatomical findings showed good agreement in benign diseases of the thyroid with lesions of more than 1 cm. Infiltrating malignant changes could not be delineated with certainty and a post mortem proven parathyroid adenoma was also missed. The practical clinical significance of thyroid phlebography is therefore confined to the localisation of parathyroid tumours in primary hyperparathyroidism by selective parathoromone measurements.

Adenoma↗
PubMed1975

[Thyroid phlebography and selective venous sampling for parathormone estimations in primary hyperparathyroidism (author's transl)].

Selective venous sampling for parathormone estimations has become an important method in the diagnosis of primary hyperparathyroidism and, together with thyroid phlebography, is an accurate means for localising hormone active parathyroid tissue. Thirty-three patients were examined by this technique and in 25 of these an exploration was carried out subsequently. Twenty-one had primary hyperparathyroidism. In one case hormone analysis lead to a false positive finding. In 18 of these 21 patients, the hormone-active parathyroid tissue was correctly localised. Phlebography showed evidence of an adenoma in five patients, but is of most use for localising the source of the hormone.

Adenoma↗
PubMed1978

[Phlebography of the testicular veins for varicoceles and their recurrences (author's transl)].

The clinical significance of varicoceles depends on their frequency and on the fact that they may produce infertility. The available operative forms of treatment are unsuccessful in about 10% of patinents. In these cases it is desirable to elucidate the very variable drainage pattern by means of transfemoral phlebography with the patient erect. The method was employed in 13 patients and demonstrated continuity of the testicular vein, or of one of its tributaries, in twelve. If the testicular vein appears to be absent, one must consider the possibility of a venous short circuit or drainage of the pampiniform plexus into the external iliac vein. In four patients out of the 13, scrotal phlebography in addition for complete definition was necessary.

Adolescent↗
PubMed1979

[The technique and results of spermatic vein phlebography in 136 men with primary sterility (author's transl)].

The results of selective phlebography of the spermatic vein in patients with primary sterility and suspected varicoceles are reported. In 60% of those examined there was left-sided, and in 8.8% right-sided, spermatic vein insufficiency or a varicocoele. The value of spermatic vein phlebography is borne out by the large number of anomalies of the venous system (67%) and by the finding of 82 left-sided varicoceles.

Adult↗
PubMed1979

[Radio-nuclide phlebography: methods, indications and clinical value (author's transl)].

Radionuclide venography (RNV) is an easily performed, rapid and non-invasive diagnostic examination for the detection of deep-vein thrombosis. Provided the procedure is followed out in a standardized order, the results are highly reliable and accurate, especially in the iliac and femoral veins. Therefore, because of this advantage and the possibility of simultaneous lung perfusion scanning and the lack of serious complications this method fills a gap between contrast phlebography and fibrinogen test. 122 limbs of 69 patients were investigated by RNS. 65% showed pathologic results. In 48% thrombotic venous occlusions could be demonstrated. Pulmonary embolic perfusion defects were found in 46% of patients presenting deep vein thrombosis but only in 15% of patients without pathologic findings in RNV. In correlation with contrast phlebography in 11 patients there was no discrepancy neither in recognition nor in localization of the thrombotic occlusion. The essential findings in RNV and the resulting diagnostic conclusions are demonstrated.

Humans↗
PubMed1990

[MR-angiography (MRA) in deep leg and pelvic venous thrombosis: a comparison with phlebography].

MRA by means of flow-phased gradient echo sequences is a valuable addition to phlebography for showing the extent of thrombosis in the veins of the pelvis and lower limbs. In eight out of 32 patients in whom the extent of deep vein thrombosis was not clearly shown by phlebography, it was possible to demonstrate the involvement of the inferior vena cava. Three of these patients had bilateral pelvic vein thrombosis. In seven out of 32 cases, thrombosis on the opposite side, which was not apparent clinically, could be demonstrated by MRA. Seven out of 32 patients showed involvement of the internal iliac vein. MRA is also valuable for observing the effect of treatment.

Adolescent↗
PubMed1990

[Clinical and technical experiences with digital luminescent radiography in phlebography of the leg].

Digital luminescence radiography is being increasingly integrated into clinical routine work and is fundamentally suited to replace x-ray film/screen takes. After the necessary optimization of the specific image processing procedure we examined the diagnostic efficacy of this method in respect of phlebography of the leg. If the radiation dose was reduced by 47% in relation to the reference system, the usefulness of the findings in arriving at the diagnosis was by no means reduced under the conditions of high contrast that apply in phlebography, but there was also no additional advantage in respect of diagnostic accuracy. The technical advantages concern mainly the absence of wrong exposures, the possibility of subsequent processing of the image to improve the image quality, and digital storage.

Evaluation Studies as Topic↗
PubMed1986

[Persistent varicocele following high ligation of the internal spermatic vein. Phlebography and vaso-occlusion with ethibloc].

The importance of phlebography and vaso-occlusion using ethibloc in diagnosis and treatment of the persistent varicocele following ligation ("Bernardis' technique") is demonstrated. We performed 280 surgical ligations of the internal spermatic vein. In 30 patients persistence of the varicocele was found. In 9 patients following phlebography embolisation of a long segment including smaller collaterals was performed using ethibloc. The other 21 patients were treated surgically because of unusual draining of the collaterals into renal capsular veins, into the hemiazygos vein and into renal segmental veins. In all cases following embolisation complete resolution of the varicocele was observed within 3 months.

Diatrizoate↗
PubMed1983

[Special complications in leg phlebography].

Some rare, but serious, complications during leg and pelvic phlebography are described. One fatal pulmonary embolus and six cases of necrosis of the dorsum of the foot due to phlebography were encountered. The causes, pathogenetic factors and other possible complications are discussed. Extravasation of contrast due to puncture on the lateral side of the foot, or near the ankle joint, leads to the formation of a contrast bleb which may proceed to tissue necrosis.

Adult↗
PubMed1983

[Digital subtraction phlebography].

The usefulness of digital subtraction angiography of the venous system, which we have termed "digital subtraction phlebography (DSP)" was demonstrated in the region of the vena cava, the pelvic veins and the veins of the arms. DSP is especially of diagnostic value in the region of the vena cava and pelvic veins and offers no advantage in the veins of the lower extremities compared to conventional phlebography. DSP is a time--and cost--saving method, furthermore minor concentrations of contrast media are needed.

Aorta, Thoracic↗
PubMed1981

[Semi-quantitative functional phlebography (author's transl)].

The ascending phlebography of the lower extremity gives no functional evaluation of venous blood-flow under the activity of the venous muscular pump. A newly developed semiquantitative method of functional phlebography by videodensitometry extends the measurability of vein dynamic. The influence of compression hoses on venous flow dynamics associated with varicose veins is examined by this method.

Absorptiometry, Photon↗
PubMed1975

Comparison of 125I fibrinogen count scanning with phlebography for detection of venous thrombi after elective hip surgery.

A comparison was made of 125I fibrinogen count scanning and phlebography in 142 limbs of 83 patients without known prior deep venous thrombosis who underwent total hip replacement. A localized accumulation of fibrinogen located away from the hip wound represented a fresh thrombus in 25 of 29 cases (86 per cent). However, of all the fresh thrombi demonstrated by phlebography, the fibrinogen scan detected only approximately 50 per cent. Major reasons for failure to detect thrombi were the presence of the wound and the small size of some thrombi. In defining whether or not fresh venous thrombosis was present in a given patient, the scan was accurate in three quarters of the cases. We conclude that fibrinogen scanning is a useful examination in patients after elective hip surgery, but less accurate than previously reported.

Fibrinogen↗
PubMedDate not supplied

Iohexol in phlebography of the leg. A comparative investigation with meglumine metrizoate.

Comparing iohexol 240 mg I/ml, iohexol 300 mg I/ml and meglumine-Ca metrizoate 200 mg I/ml in phlebography of the leg in patients on or without anticoagulants, no sign of postphlebographic thrombosis was found using the 125I-fibrinogen uptake test and repeat phlebography. More adverse reactions occurred with metrizoate than with iohexol. Metrizoate provided significantly poorer demonstration than the two iohexol concentrations with higher iodine content.

Adult↗