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Optimization of ascending phlebography of the leg for screening of deep vein thrombosis in thromboprophylactic trials.

PURPOSE: Comparison of 2 phlebographic techniques in achieving adequacy of deep venous filling. MATERIAL AND METHODS: Sixty consecutive patients with a clinical suspicion of deep vein thrombosis (DVT) were examined by 2 different techniques. A according to GREITZ and B according to LEA THOMAS. All deep veins were scored according to a protocol as DVT, normal or inadequate. Venous evaluability and DVT rates were compared. Bilateral phlebograms according to the A-technique from 92 asymptomatic patients in a different trial were reviewed to allow comparison with the symptomatic subjects. RESULTS: The A-technique resulted in a significantly higher degree of overall evaluable patients compared to the B-technique, 95% vs 47%. A vein-by-vein analysis showed that the A-technique was significantly better than the B-technique in filling the gastrocnemius muscular (82% vs 38%), anterior tibial (85% vs 43%), and deep femoral (28% vs 18%) veins. No significant difference was found in the other veins. The DVT rates were 42% and 40% respectively for the A- and B-techniques. About 94% of the phlebograms in the asymptomatic patients were adequate. CONCLUSION: The A-technique resulted in better venous opacification and would seem to be a more suitable screening method for asymptomatic persons.

Adult↗

Female "varicocele": two cases diagnosed by labeled red blood cell angioscintigraphy and treated by percutaneous phlebography and embolization.

Varicocele, a varicosity of the gonadal venous plexus, is a well-recognized disorder occurring in up to 10% of men. In women, an analogous varicosity of the salpingo-ovarian plexus is rare. This may be explained, in part, by the lack of obvious findings on clinical examination in women compared with men and the need, until recently, to use invasive venographic methods to confirm the diagnosis. Two cases of "female varicocele" diagnosed by means of echo Doppler and Tc-99m red blood cell scintigraphy and their cure by percutaneous phlebographic occlusion of the ovarian venous varicosity are described.

Adult↗

Ioversol in ascending phlebography--a clinical trial.

In this controlled randomised double-blind parallel group study of the use of ioversol-240 and ioversol-320 in venography all studies were considered diagnostic with comparable quality in the two groups. Patient tolerance was high with mild heat observed in 7 patients in the ioversol-320 group and 1 patient in the ioversol-240 group. Assessment of pain was also comparable (2 patients in the ioversol-240 group and 1 in the ioversol-320 group). Both strengths of the contrast agent produced no clinically significant, drug related, changes in vital signs or laboratory parameters and there were no significant clinical adverse reactions.

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