Lower extremities phlebography is an X-ray contrast study conducted to assess the nature of blood flow, condition and anatomical structure of the peripheral parts of the venous system. It is performed for varicose veins, deep vein thrombosis, post-thrombophlebitic disease and vascular abnormalities in case of insufficient information content or unavailability of less invasive diagnostic methods. The patient is laid on his back, a catheter is inserted into the peripheral vein. Then the patient is transferred to an upright position and a contrast agent is injected through a catheter. A tourniquet is applied to the limb to accelerate the filling of deep veins. Perform a series of snapshots.
Preparation of lower extremities phlebography
- During the four hours before the study, you can not eat, and you can only drink water.
- Patients who are allergic (in particular to iodine) or have already had a reaction to contrast should inform their doctor about this.
- A sedative may be prescribed to calm the patient.
- You may be asked to observe certain dietary restrictions before the study, depending on the specific procedure.
- Tell your doctor about the medications, herbs, or supplements you are taking. You may be advised to stop taking some of these medications before the study.
Methodology of conducting
During the procedure, the patient lies on a special X-ray table. The area where the catheter will be inserted is cleaned (usually it is a vein on the arm, so that any necessary medications can be administered during the procedure). Sometimes local anesthesia is administered.
A contrast solution is delivered through the catheter. Injection of the dye causes a feeling of warmth that can spread through the body. The contrast can also cause mild nausea. About 18% of patients experience discomfort from the contrast solution. To fill the deep venous system with dye, a dense tape (or tourniquet) is sometimes applied around the ankle, or the limbs may be tilted. The patient is asked to keep the leg still. The doctor observes the movement of the solution through the vein using a fluoroscope. At the same time, a series of pictures is taken.
When the lower extremities phlebography completed, a saline solution is injected into the same catheter to clear the veins of contrast, then the catheter is removed and a bandage is applied to the injection site.
After diagnosis
After phlebography, it is necessary to be monitored in the clinic for at least a day. Depending on the procedure, it may be recommended to rest in bed for a certain period of time.
Patients should drink a large amount of liquid to flush the remaining contrast solution from the body.
The area at the catheter insertion site may ache for several days. If you notice swelling, redness, pain, or fever, tell your doctor. In most cases, the patient can resume normal activities the next day.
Complications
Phlebography can cause complications such as phlebitis, tissue damage and the formation of deep vein thrombosis in a healthy leg. Complications are quite rare, but they should be taken into account when planning treatment so that the risk of the study does not exceed the risk of the disease for which it is being conducted.
A rare side effect (up to 1% of cases) is a serious allergic reaction to a contrast dye. It usually manifests itself 30 minutes after the injection of the dye and requires medical attention.
Possible risks include the formation of a blood clot in a vein, bleeding, damage to blood vessels or infection at the site of catheter insertion.
Some people may experience an allergic reaction to an iodine-based contrast dye. This can cause symptoms such as nausea, sneezing, vomiting, urticaria, and sometimes a life-threatening reaction called anaphylactic shock (especially in elderly patients with chronic dehydration or mild renal failure).
