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Lower Leg Venography
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Lower Leg Venography

(Phlebography; Venogram)

En Español (Spanish Version)

Definition

Venography is an x-ray test used to study the veins of the body. It is now used infrequently because ultrasound studies are a less invasive way to get the needed diagnostic information.

Parts of the Body Involved

The venographys uses the veins in the foot.

Reasons for Procedure

Venography may be used to:

  • Diagnose deep vein thrombosis , a blood clot deep within the leg that may lead to an obstruction of a blood vessel in the lungs ( pulmonary embolism )
  • Distinguish blood clots from obstructions in the veins
  • Evaluate congenital vein problems
  • Assess the functioning of deep leg vein valves
  • Identify a vein for arterial bypass grafting

Deep Vein Thrombosis

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Risk Factors for Complications During the Procedure

The presence of any of the following conditions may make it difficult for the clinician to view the veins:

  • Previous thrombosis
  • Dilution of the contrast dye in the lower limb
  • Difficulty accessing the veins due to:

What to Expect

Prior to Procedure

You may be asked to fast or drink only clear fluids for four hours before the test. Tell your doctor if you have a history of allergies, hay fever, or bad reactions to an injected contrast dye. If you are nervous about the test, your doctor may give you a sedative.

During Procedure

You will lie on a tilting x-ray table. If necessary, you will be shaved in the area where the catheter (small tube used to inject the dye) will be inserted. A small incision may be made in that area as well.

Anesthesia

You may be given a local anesthetic to numb the area where the catheter will be inserted.

After Procedure

The leg catheter will be removed and a bandage applied over the site of the injection. You should arrange to have someone drive you home.

Description of the Procedure

The catheter is inserted into your vein (usually a vein in the foot) and a special dye is slowly injected. A tight band may be tied around your ankle, or your lower body may be tilted, which helps to fill the deep venous system with dye. You will be asked to remain still as a clinician uses a fluoroscope to view the movement of the dye through your veins. A series of x-rays will be taken during this time.

How Long Will It Take?

The procedure takes about 30 minutes for an uncomplicated venography. This time may increase, depending on the specifics of the procedure. Furthermore, you will need to keep your leg straight for six hours after the procedure has been completed.

Will It Hurt?

You may experience some pain at the injection site during the test, and soreness for a few days after. Some people experience mild discomfort throughout the body, or nausea, as the contrast dye fills the veins.

Possible Complications

Possible complications include:

  • Infection at the injection site
  • Tissue damage
  • Phlebitis (inflammation of a vein)
  • Allergic reactions to the contrast dye
  • Congestive heart failure
  • Acute renal insufficiency
  • Venous thrombosis in a healthy leg
  • Dislodging a clot, perhaps resulting in pulmonary embolus or other complications

People with kidney problems or diabetes , especially those taking metformin (Glucophage), may have a higher risk for complications resulting from venography.

Average Hospital Stay

Venography does not require hospitalization.

After the Procedure

  • When you get home from the test, take it easy for the rest of the day and try to avoid going up and down flights of stairs, or any strenuous activity.
  • Drink large amounts of fluid for the next 24 hours, to help flush the remaining dye from your body.
  • If any bleeding or swelling occurs at the injection or puncture site, put pressure on the site for at least 10 minutes. If this fails to stop the bleeding, go to the emergency room of a local hospital or call your physician for advice.
  • You may remove the bandage the day after your test.
  • Observe the injection site for any swelling, heat, redness, pain, or drainage. The injection area will be sore for a few days.

Most people are able to resume normal activities the day after the procedure.

Outcome

A normal venography means that the blood flow through the vein is normal. An abnormal venography means that there is an obstruction of blood flow through the vein, which may be caused by a blood clot, tumor, or inflammation.

Call Your Doctor If Any of the Following Occurs

  • Fever
  • Swelling, redness, or pain

RESOURCES:

National Heart, Lung, and Blood Institute, NIH
http://www.nhlbi.nih.gov/health

Society of Interventional Radiology
http://www.sirweb.org

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca/home/index_e.aspx

University Health Network
http://www.uhn.ca/index.asp

References:

Care instruction following outpatient venography. University of Iowa Health Care website. Available at: http://www.radiology.uiowa.edu . Accessed on November 22, 2004.

Diagnostic Imaging of Lower Limb Deep Venous Thrombosis. American Academy of Family Physicians website. Available at: http://www.aafp.org . Accessed on November 22, 2004.

Penn State Vascular Institute website. Available at: http://www.hmc.psu.edu/vascularinstitute/services/diagveno.htm . Accessed on November 22, 2004



Last reviewed November 2007 by Rosalyn Carson-DeWitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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