Press phlebography

This article was based on formal and / or substantive defects on the quality assurance side of the editorial Medicine entered. Please help fix the shortcomings in this article and join the discussion there . The minimum requirements for medical articles are to be met, thereby avoiding a possible deletion of the article or article passages within four weeks.

The phlebography (also ascending phlebography ) is a variant of venography , which is carried out mainly in suspected impaired venous valve function or varices. It is considered the reference method ("gold standard").

It is usually carried out using the method developed further by W. Hach in 1976.

execution

This examination is usually carried out in the same session as the venography. The patient is positioned on a tilting table at an angle of 45-60 degrees. Contrast agent is injected into the vein through an intravenous access on the back of the foot of the leg to be examined . So that the contrast agent does not flow into the superficial but into the deep veins to be examined, the superficial ones are blocked with an ankle congestion, i.e. tied off. In the subsequent x-rays, the leg veins are shown and examined for pathological changes. A thrombosis, for example, is characterized by a clearly delimited filling defect.

In press phlebography, the venous valve function is examined in particular. For this purpose, the patient is asked to perform a Valsalva maneuver (forceful exhalation with closed mouth and nose) or to tense the abdominal muscles. This pressing artificially increases the venous pressure for a short time. If the venous valve function or varices are disturbed, a pathological reflux can be shown radiologically.

literature

Eberhard Rabe, Horst-Eberhard Gerlach: Practical Phlebology: Recommendations for the differentiated diagnosis and therapy of phlebological diseases . 2., completely revised Edition. Thieme, Stuttgart 2006, ISBN 3-13-119232-1 .
AN Nicolaides: Investigation of Chronic Venous Insufficiency. In: Circulation. 102, 2000, doi : 10.1161 / 01.CIR.102.20.e126 .
C. Jeanneret, KH Labs, M. Aschwanden, A. Bollinger, U. Hoffmann, K. Jäger: Physiological reflux and venous diameter change in the proximal lower limb veins during a standardized Valsalva maneuver. In: European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery. Volume 17, Number 5, May 1999, pp. 398-403, doi : 10.1053 / ejvs.1998.0797 , PMID 10329523 .
J. Weber: Phlebography for the representation of the leg and pelvic veins. In: E. Zeitler: (Ed.) Arterien und Venen. Clinical radiology (diagnostics with imaging methods). 1997, Springer, Berlin, Heidelberg Print ISBN 978-3-642-64380-4 Online ISBN 978-3-642-60381-5

Individual evidence

↑ S2K guideline 037-018, diagnosis and treatment of varicose veins
^ W. Hach: Phlebography of the leg and pelvic veins, 1985 2nd edition Schnetztor, Konstanz
^ W. Hach, V. Hach-Wunderle, H. Meents, AL Strauss: Invasive investigation methods. In: H. Rieger, W. Schoop (Ed.): Clinical Angiology. Springer, Berlin, Heidelberg 1998, print ISBN 978-3-662-08105-1, online ISBN 978-3-662-08104-4

[1] S2K guideline 037-018, diagnosis and treatment of varicose veins

[2] W. Hach: Phlebography of the leg and pelvic veins, 1985 2nd edition Schnetztor, Konstanz

[3] W. Hach, V. Hach-Wunderle, H. Meents, AL Strauss: Invasive investigation methods. In: H. Rieger, W. Schoop (Ed.): Clinical Angiology. Springer, Berlin, Heidelberg 1998, print ISBN 978-3-662-08105-1, online ISBN 978-3-662-08104-4