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Abstract:
The authors describe a technique for retrograde phlebography of the lower limbs that involves introducing a Cournand catheter into the superior system via one pf the basilic veins so that it reaches the inferior vena cava, passing through the right atrium. The new feature of this method, which has been previously used by Dow and Gillot, is that the catheter may be passed fairly low into the iliac or femoral veins. Thus with a single catheter it is possible to carry out cavography, bilateral phlebography of the external iliac veins or even the internal iliacs, or bilateral femoral phlebography. The most suitable indications for the this technique include (1) the search for a residual cross after stripping, (2) the assessment of recent iliac thrombosis when there is an indication for surgery, (3) the assessment of a "swollen leg" when there is a doubt in diagnosis between lymphoedema and phleboedema, and (4) the study of deep repermeabilization in cases of post-phlebitic syndrome (before eventual surgery of the saphenous veins). This examination, which should be carried out in a vascular radiology unit; makes it possible to obtain films of good quality that are easy to interpret and that provide a very complete phlebographic assessment.