1994 UPDATE ON PHLEBOGRAPHY AND VARICOGRAPHY

BACKGROUND. Appropriate management of venous disease requires definiti ve diagnosis. The place of phlebography and varicography in acute and chronic venous disease is to complement other less invasive and less e xpensive 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 i n our environment. METHODS. The technique of each type of phlebography are outlined. These include ascending phlebography at the foot, popli teal and femoral levels, varicography, and descending phlebography. Co mplications are discussed briefly. RESULTS. The advantages and complic ations of each method are discussed with the description of the proced ures. CONCLUSION. The most frequent uses of phlebography in acute veno us thrombosis are to define deep vein thrombosis isolated to the calf or to the iliac veins, or to clarify findings from duplex scan examina tions. In chronic venous disease, phlebography is used to clarify prob lem cases of superficial venous disease and to study patients with adv anced deep vein disease who are potential candidates for deep vein rec onstruction.