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A method of performing descending venography.

R L Kistner, E B Ferris, G Randhawa

Journal of Vascular Surgery

|November 1, 1986

Summary

Descending venography is a key diagnostic tool for evaluating lower extremity venous valve incompetence. This standardized technique accurately assesses valve function, aiding in treatment decisions for venous insufficiency.

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Area of Science:

Vascular Surgery
Diagnostic Imaging
Venous Physiology

Background:

Successful surgical correction of lower extremity venous valve incompetence necessitates precise diagnostic methods.
Current diagnostic approaches require standardization for accurate assessment of venous valve function.

Purpose of the Study:

To describe a standardized technique for descending venography.
To establish a method for interpreting descending venography, analyzing individual valve function and overall valvular competence.
To differentiate primary valve incompetence from postthrombotic valve destruction and valve aplasia.

Main Methods:

Detailed description of catheter placement, injection procedures, and monitoring techniques for descending venography.
Utilized the Valsalva maneuver to "stress" venous valves and assess function.
Compared descending venographic findings with clinical status and venous pressure measurements in 78 extremities.

Main Results:

Descending venography accurately defines the location and degree of venous valve incompetence.
The technique allows differentiation between primary valve incompetence and postthrombotic valve destruction.
Valsalva maneuver effectively stresses valves for functional assessment.

Conclusions:

A standardized descending venography technique provides accurate assessment of lower extremity venous valve function.
This diagnostic modality is crucial for guiding treatment strategies for venous insufficiency.
The method aids in distinguishing etiologies of venous valve incompetence, informing patient management.

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