[Phlebological diagnosis. Phlebography of the veins of the lower extremity]

Phlebography should be weighed up against the current sonographic techniques (Doppler and Duplex) applied for visualization of venous disorder along the lower extremity veins, following a decision tree considering completeness and quality of documentation wanted, invasiveness and clinical consequences expected in the individual case. Ascending leg phlebography, incorporating Valsalva's manoeuvre, means the up-to-date standard technique, offering morphologic and functional information. Varicography and additional phlebographic techniques are considered to be additive, solving special problems, having not been visualized by the standard phlebography before. Combined phlebography and peripheral blood pressure measurements may improve the output of functional informations within one session. Quality standards of phlebography have to include standardized technique of phlebography, of documentation and interpretation, dealing with the special aspects of varicose syndrome, acute thrombosis and the post-thrombotic syndrome.