Phlebography is an X-ray imaging examination of the veins in the arms and legs. It enables the doctor to assess the superficial and deep venous system. He can check their sale and discover indications of diseases. The following text explains what phlebography is, how it is used and which diseases can be diagnosed with its help.
Here you will find further information and selected phlebography specialists.
Phlebography is an X-ray examination to diagnose venous diseases. It is part of the specialty of radiology. "Phlebos" means belonging to veins and "graphy" means representation.
A contrast agent is administered before the X-ray to improve visualization. Using phlebography, doctors can
can be examined. However, the latter is less common. This procedure allows the veins to be visualized well. This makes it easier to assess whether
Phlebography is used in phlebology.
Phlebology is the "study of diseases of the veins". "Phlebology" is an additional title to the specialist title. It shows that the specialist in question has completed further training in phlebology.
Specialists in general medicine, surgery or skin and sexually transmitted diseases(dermatologists) can acquire this additional qualification.
Phlebography is able to image the veins so well that
can be detected. This examination can be carried out in addition to computer tomography, magnetic resonance angiography or ultrasound (sonography), for example. Sometimes, although rarely, these procedures are not conclusive enough. Phlebography can then help.
The reason for carrying out a phlebography is usually a suspected venous disease or an obstruction to blood flow.
However, the implantation of a pacemaker and a dialysis shunt also require precise knowledge of the outflow conditions of the veins. A phlebography of the arm veins can prepare for these interventions.
Occasionally, the results of the imaging venous examination may require further diagnostic procedures. These include, for example, a blood test in the laboratory. If no vein-related explanation for a blood clot can be found, certain blood properties may be responsible.
Complementary computer tomography may also be advisable. This allows subsequent vein areas, such as the pelvic veins, to be visualized.
Phlebography can show non-functioning venous valves that lead to varicose veins © Solarisys | AdobeStock
A conventional X-ray image does not distinguish veins clearly enough from the surrounding tissue. A contrast agent containing iodine is injected into the vein to improve the visualization of the vein.
The examination is carried out with the patient lying down. The contrast agent is injected into the vein via the back of the hand or foot using a fine needle. As with blood sampling, a tourniquet, pressure bandage or cuff is applied so that the veins fill up and the slowly injected contrast medium first collects in the deeper vein areas before it is distributed further in the superficial and draining veins. The flow of contrast medium can be visualized using an X-ray machine.
The examination is hardly painful and in this respect is comparable to injections in general. Tension or slight pain may occur, which quickly subsides.
During the phlebography, the patient is asked to perform certain breathing exercises. In this way, possible venous valve defects can be detected.
The examination procedure is also well suited to documenting the limb in various stages of movement and different positions of the person being examined.
Phlebography takes 5 to 10 minutes on average, but can also take 15 to 20 minutes. It should be 2 to 4 hours since the last food intake, including drinking.
Phlebography is performed on an outpatient basis. Afterwards, the patient should move the examined limb - arm or leg - extensively and also drink plenty of fluids. This speeds up the removal and excretion of the contrast agent administered.
Your doctor will inform you whether and to what extent a follow-up examination is necessary.
Phlebography is a routine medical examination. Its use is therefore tried and tested. Nevertheless, the examination is associated with a few side effects and risks:
Phlebography is not possible for some patients. Contraindications may include special physical characteristics or certain pre-existing conditions. Examples of contraindications are
The contrast agent puts a strain on the kidneys. Patients with kidney disease should therefore ask their family doctor about the individual risks.
A supplementary blood test to check kidney and thyroid function is recommended.
The doctor will discuss the details of the examination with the patient in an informative consultation. This also includes a discussion of possible risks. Bring the following to the consultation
with you. Possible risks can be largely eliminated in such a detailed preliminary discussion.
In the past, people with an intolerance to contrast media sometimes experienced allergic shocks with breathing difficulties and circulatory problems. Nowadays, this only happens very rarely. The X-ray contrast media commonly used today are better tolerated.
A lower dose of contrast medium is also required today than in the past to obtain a meaningful image.
Some people have to do without phlebography for health reasons. In this case, they can use other, radiation-free methods to examine their veins.
Suitable alternatives to phlebography are
The requirements for vein examinations are very individual. Therefore, treating physicians decide which alternative examination method is most promising in each individual case.
The success of a phlebography depends on the findings obtained from this vein examination and the subsequent further treatment.
Phlebography can confirm or rule out a suspected thrombosis. The doctor will then remove the blood clot found or look for another cause of the symptoms.
This examination method can also be carried out several times to monitor the progress of thrombosis treatment. If varicose vein surgery is planned, the X-ray image documents the condition of the veins and makes it easier to plan the operation.
Phlebography is an informative and generally well-tolerated imaging procedure. However, a vein must be punctured and iodine-containing contrast medium injected, which entails risks and has numerous contraindications. For this reason, ultrasound examinations are preferred nowadays, as they can clarify most phlebological issues. Alternatively, computer tomography is used in a few cases. Phlebography, which used to be performed more frequently, is now only used in exceptional cases.
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