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At least 19 recordsLinked to original sources
PubMed1998

[Discrepancies between the results of phlebography and Doppler ultrasonography in the diagnosis of asymptotic venous thrombosis after total hip prosthesis. False negatives of phlebography or false positives of Doppler ultrasonography].

OBJECTIVES: Assess the diagnostic performance of phlebography and discrepancies with duplex ultrasonography in screening for asymptomatic deep vein thrombosis after total hip arthroplasty. Search for arguments which would favor contributing false-negatives or false-positives to one of the two exploration methods. PATIENTS AND METHODS: The study included 24 patients who underwent the 2 explorations independently between day 7 and day 14 in a multicentric therapeutic trial of a new heparin. Discrepancies between the two techniques were recorded. Diagnostic performance of phlebography was calculated from contingency tables. The phlebograms were then reviewed with knowledge of the duplex ultrasonographic findings. The course of the venous thrombus after treatment was monitored with duplex ultrasonography. RESULTS: Phlebography allowed the diagnosis of thrombus formation in 9 patients. Ultrasonography provided the diagnosis in 14 cases out of 24. Sensitivity of phlebography compared with duplex ultrasonography was 64% (95% CI = 35.1-87.2) (9/14) and specificity was 100% (95% CI = 69.1-100) (10/10). Several localizations were not visualized with phlebography: 3 partially obstructive thrombi near the femoral junction, and 38 distal thrombi including 31 soleus thrombi (fig. 5). When the phlebograms were reviewed again, defects compatible with a partial thrombus were found for the 3 proximal localizations and for 2 of the distal localizations (fig. 1, 2, 4). None of the soleus localizations were visualized. Duplex ultrasonographic follow-up concerned 12 of the 14 patients with a thrombus identified by duplex ultrasonography involving 44 localizations. In five case, the operator was different from the operator for the initial duplex ultrasonography. Follow-up revealed: 1 new localization, 37 narrowings and 6 repermeabilizations. DISCUSSION: The coherence of the duplex ultrasonographic follow-up and the presence of images compatible with partial thrombus on the revised phlebograms which had been initially interpreted as wash out flow constitute a group of arguments suggesting that the discrepancies observed should be considered as phlebography false-negatives. This defect in the sensitivity of phlebography has been reported by others in the literature both for distal and proximal localizations.

Aged↗
PubMed1976

Cuff-impedance phlebography and 125I fibrinogen scanning versus roentgenographic phlebography for diagnosis of thrombophlebitis following hip surgery. A preliminary report.

Seventy-eight limbs of forty-eight patients undergoing total hip replacement were studied by roentgenographic phlebography, cuff-impedance phlebography, and 125I fibrinogen scanning. Compared with roentgenographic phlebography, cuff-impedance phlebography detected seven of ten thrombi in the thigh but none of nine thrombi in the calf and popliteal veins, giving an over-all accuracy of 80 per cent. The 125I fibrinogen scanning technique detected none of the ten thrombi in the thigh and seven of the nine in the calf and popliteal veins, giving an over-all accuracy of 78 per cent. Combining the results of the two techniques, fourteen of the nineteen thrombi were detected. Cuff-impedance phlebography appears to be a useful method for the diagnosis of thrombi in the thigh after hip surgery.

Femoral Vein↗
PubMed1988

Surveillance of deep vein thrombosis in asymptomatic total hip replacement patients. Impedance phlebography and fibrinogen scanning versus roentgenographic phlebography.

Nine hundred thirty-seven limbs in 537 patients over the age of 39 years who underwent total hip replacement were studied by roentgenographic phlebography, cuff-impedance phlebography, and iodine-125 fibrinogen scanning. Cuff-impedance phlebography had a sensitivity of only 12.3 percent for thigh thrombi. Fibrinogen scanning had a sensitivity of only 59.1 percent for calf thrombi and 13.7 percent for thigh thrombi. The combined use of the two methods resulted in only a 23.2 percent sensitivity for thigh thrombi and an overall sensitivity of 47.4 percent. We have concluded that in asymptomatic patients, in contrast with symptomatic patients, the combination of cuff-impedance phlebography and fibrinogen scanning is not an effective screening method.

Adult↗
PubMed1992

A comparison between descending phlebography and duplex Doppler investigation in the evaluation of reflux in chronic venous insufficiency: a challenge to phlebography as the "gold standard".

To evaluate venous reflux in 56 lower limbs of 32 consecutive patients, hemodynamic tests, ascending and descending phlebography, and supine and erect quantitative duplex scanning were performed and the clinical severity was classified (class 0 = 15, class 1 = 19, class 2 = 8, and class 3 = 14). Of the 56 lower limbs, 22 (40%) had severe swelling and hyperpigmentation with or without ulcer (classes 2 and 3). Adequacy of the clinical severity classification was supported by the hemodynamic results. Radiologic and ultrasound findings were described by axial grading, multilevel/multisystem point, and multisegment scoring systems. Applying these evaluation systems, the phlebographic and scan results correlated poorly. There was no relationship between the radiologically obtained average reflux grade or points and the clinical severity. An erect quantitative duplex Doppler test assessed by the multisegment scoring system correlated best with the severity classification. The predictive value of this test to diagnose severe reflux leading to severe symptoms (classes 2 and 3) was 77% compared with 35% to 44% for descending phlebography. The study suggests that erect quantitative segmental duplex Doppler reflects the degree and distribution of venous reflux more accurately than does descending venography.

Humans↗
PubMed1993

Significance of serum immunoglobulin levels in conglomeration with trans-sternal phlebography in the phlebography management of breast cancer.

The study was conducted on 63 patients with breast lump and twenty normal healthy females. In benign breast disease, a significant (P < 0.001) rise in serum IgA, significant (P < 0.001) decrease in IgG and no change in IgM levels was seen before operation. A significant decrease (P < 0.001) in serum IgA and significant increase in IgG and IgM was observed post operatively. In carcinoma breast, a significant (P < 0.001) elevation in IgA, IgG and IgM levels was found pre-operatively with a concomitant decrease in serum IgA and IgG and increase in serum IgM levels, post operatively. Trans-sternal phlebography (TSP) carried out with 95.23% success has revealed significant (P < 0.001) change in the staging of carcinoma breast. The increased levels of serum immunoglobulins associated with the patients of carcinoma breast with metastasis has led to conclude that these levels, if punctuated with TSP findings can lead to better assessment of the staging of carcinoma breast and thereby its management.

Biomarkers, Tumor↗
PubMed1984

[Phlebography after total prosthesis. Action of subcutaneous sodium heparin in the prevention of thromboembolism. Results of therapeutic research with subcutaneous sodium heparin using 2 protocols in 250 patients monitored with phlebography].

Two series of patients on which total hip or knee prostheses had been inserted were studied. In the first series (150 cases), the patients were treated with low molecular Dextran and subcutaneous sodium heparin at a constant dosage. The Howell test was done every 3 days. The rate of post-operative thrombosis was 14 p. 100. In the second series (100 cases), the patients were treated with low molecular Dextran and subcutaneous sodium heparin with a variable dose adapted to the type of patient. The rate of post-operative thrombosis was only 7 p. 100. The insertion of a knee prosthesis was much more thrombogenic than hip prostheses. In the second series the rate of thrombosis after hip surgery was only 2 p. 100. However a number of complications relating to anticoagulation were a limiting factor of the method.

Clinical Trials as Topic↗
PubMed1995

1994 update on phlebography and varicography.

BACKGROUND: Appropriate management of venous disease requires definitive diagnosis. The place of phlebography and varicography in acute and chronic venous disease is to complement other less invasive and less expensive tests of venous function. OBJECTIVE: This paper will address the present indications for phlebography and present the techniques of ascending and descending phlebography and of varicography practiced in our environment. METHODS: The technique of each type of phlebography are outlined. These include ascending phlebography at the foot, popliteal and femoral levels, varicography, and descending phlebography. Complications are discussed briefly. RESULTS: The advantages and complications of each method are discussed with the description of the procedures. CONCLUSION: The most frequent uses of phlebography in acute venous thrombosis are to define deep vein thrombosis isolated to the calf or to the iliac veins, or to clarify findings from duplex scan examinations. In chronic venous disease, phlebography is used to clarify problem cases of superficial venous disease and to study patients with advanced deep vein disease who are potential candidates for deep vein reconstruction.

Acute Disease↗
PubMed1984

[Lumbar phlebography. Contribution to the diagnosis of lumbosciatica of disk origin].

Lumbar phlebography: its diagnostic value in lumbosciatica due to disc disease. The authors' purpose was to define the diagnostic value of lumbar phlebography in the investigation of intervertebral disc lesions and to compare these results with those obtained from clinical examination and plain X-rays. They conducted a retrospective study of 200 cases of patients hospitalized for sciatica who were investigated by lumbar phlebography using selective catheterization, without any prior neuro-radiological examination. 104 of these cases were operated on. The lumbar phlebography was interpretable in 99 p. cent of cases. Severe thrombo-embolic episodes occurred in two cases. In the 104 patients who went to operation, the surgical procedure confirmed the presence of a herniated disc (suspected on phlebography) in 96 p. cent of cases. Topographical agreement between the phlebographic data and the operative findings was observed in 81 p. cent of cases. Phlebography proved to be more reliable at L4-L5 than at L5-S1. In the patients in whom clinical examination and plain X-ray findings provided coherent information as to the site of the herniated disc, phlebography was considered to be of no use. In those patients for whom this examination did not provide coherent information, phlebography proved to be valuable in the topographical diagnosis of the herniated disc.

Adolescent↗
PubMed1994

[Development of direct phlebography for surgical intervention of the varix cruris].

To determine the appropriate treatment for patients with varix cruris, we performed three different methods of phlebography including direct phlebography, and compared their findings by each phlebography. Conventional ascending phlebography was taken routinely and initially in all limbs (n = 120). "Direct phlebography" developed by us was then indicated, when the visualization of the deep vein system was unclear by conventional ascending phlebography. This method was useful for the clear opacification of the deep vein system, and also was able to visualize the deep femoral vein clearly. After the precise diagnosis of varix cruris, descending phlebography under the Valsalva maneuver at supine position was carried out for the evaluation of the deep vein insufficiency. According to these phlebographic findings, conventional stripping with or without sub- or suprafascial ligation of communicating vein was indicated to saphenous typed varix cruris. The valvuloplasty to the highest valve in superficial femoral vein was carefully added in eight limbs which showed the significant reflux by added in eight limbs which showed the significant reflux by the descending phlebography. This valvuloplasty was remarkably contributed to the immediate healing of the stasis ulcer without recurrence. And compression sclerotherapy was selected to some patients with branch typed varix cruris.

Adolescent↗