Deep vein thrombosis venography

Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] ; Kashish Goel, M.D.; Assistant Editor(s)-In-Chief: Justine Cadet

Overview

Venography is the gold standard to diagnose venous thrombosis, however it is not the preferred test in clinical settings. It includes injection of contrast into the dorsal foot vein and checking for a intraluminal filling defect that is present in more than one view.^[1]

Venography

Potential Problems

Venography has gone out of favor and is unsuitable for clinical practice because of the following reasons:

Invasive procedure
Expensive
Not available widely
Large intra-observer and inter-observer variation
Side effects of contrast administration including severe allergy, nephrotoxicity, nausea, dizziness, etc
Up to 20% of tests are inadequate for assessment
Post-venography DVT (0-2%)

References

↑ Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ; et al. (2012). “Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines”. Chest. 141 (2 Suppl): e419S–94S. doi:10.1378/chest.11-2301. PMC 3278049. PMID 22315268.

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[pmid22315268-1] Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ; et al. (2012). “Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines”. Chest. 141 (2 Suppl): e419S–94S. doi:10.1378/chest.11-2301. PMC 3278049. PMID 22315268.

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