Optimization of ascending phlebography of the leg for screening of deep vein thrombosis in thromboprophylactic trials.
OBJECTIVE
Comparison of 2 phlebographic techniques in achieving adequacy of deep venous filling.


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.


CONCLUSIONS
The A-technique resulted in better venous opacification and would seem to be a more suitable screening method for asymptomatic persons.
Kälebo
P
P
Department of Radiology, Ostra Hospital, University of Göteborg, Sweden.
Anthmyr
B A
BA
Eriksson
B I
BI
Zachrisson
B E
BE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010690:Phlebography / Q000379:methods*; D012680:Sensitivity and Specificity; D013924:Thrombophlebitis / Q000175:diagnosis* / Q000517:prevention & control