• Lower Leg Venography

    (Phlebography; Venogram)

    Definition

    Venography is an x-ray test used to study the veins of the body. Lower leg venography is used to study the veins in the legs.

    Reasons for Test

    • 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 )
    • Find obstructions in the veins
    • Assess vein problems you have had since birth
    • Assess the functioning of deep leg vein valves
    • Find a vein that will be used to make a bypass graft
    Deep Vein Thrombosis
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    Possible Complications

    Some possible complications with this test include:
    • Infection
    • Tissue damage
    • Phlebitis—inflammation of a vein
    • Allergic reactions to the contrast material
    • Kidney damage
    • Forming blood clots
    People with kidney problems or diabetes , especially those taking metformin (Glucophage), may have a higher risk for complications from venography.

    What to Expect

    Prior to Test

    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 injected contrast. If you are nervous about the test, your doctor may give you a sedative.
    Arrange for someone to drive you home.

    Description of Test

    You will lie on a tilting x-ray table. You will be cleaned in the area where the catheter (small tube used to inject the contrast) will be inserted. A small cut in your skin may be made in that area as well. You may be given a local anesthetic to numb the area where the catheter will be inserted.
    The catheter is inserted into your vein (usually a vein in the foot) and the contrast is slowly injected. A tight band may be tied around your ankle or your lower body may be tilted. This helps to fill the veins with contrast. You will be asked to remain still as the doctor uses an x-ray machine to view the movement of the contrast through your veins.

    After Test

    The catheter will be removed and a bandage will be put over the site of the injection.
    • When you get home from the test, take it easy for the rest of the day and try to avoid any strenuous activity.
    • Drink large amounts of fluid for the next 24 hours to help flush the remaining contrast from your body.
    • 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 may be sore for a few days.
    • If any bleeding or swelling occurs at the injection or puncture site, put pressure on the site for at least 10 minutes.
    Ask your doctor about when it is safe to shower, bathe, or soak in water. Most people are able to return to normal activities the day after the test.

    How Long Will It Take?

    The test takes about 30 minutes. This may be longer depending on the specifics of the test.

    Will It Hurt?

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

    Results

    A normal venography means that the blood flow through the vein is normal. An abnormal venography means that there is something blocking blood flow through the vein. Based on the results, your doctor will discuss further studies or treatment.

    Call Your Doctor

    After the test, call your doctor if any of the following occurs:
    • Fever or chills
    • Swelling, redness, or pain at the injection site
    • Itching, rash, or other signs of an allergic reaction

    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%5Fe.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

    Revision Information

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