Venography

Venography is a specialized imaging technique used to examine the venous vessels, particularly in the legs and arms. It involves the injection of contrast material, making the veins clearly visible on X-ray images. This procedure is important for diagnosing various venous diseases, including deep vein thrombosis (DVT), venous insufficiency, and other abnormalities affecting blood flow in the venous system. At "Dobrobut" clinics, we utilize venography for accurate diagnostics and effective treatment strategies for patients.

When to See a Doctor

Patients should consult a doctor and possibly undergo venography if they exhibit any of the following symptoms:

• Swelling of a limb on one side, which may indicate a venous problem, especially if accompanied by pain or heaviness.
• Pain, increased sensitivity, or disturbances such as a “pins and needles” sensation. Sharp or pulsing pain in the limb, particularly when standing or walking, may indicate a clot or blockage of a venous vessel.
• Changes in skin color. The affected areas might appear red or take on another color, indicating the need for further investigation of blood flow.

• Warmth in the limb. If the skin over the affected area feels warmer to the touch compared to surrounding areas, this may be a sign of inflammation or thrombosis.
• In cases of pulmonary embolism, symptoms may include sudden shortness of breath, a rapid heartbeat, or chest discomfort.

Indications and Contraindications for Venography

Venography is a diagnostic procedure used for visualizing veins and typically involves the injection of contrast dye. It is primarily indicated for evaluating the structure and function of veins in various conditions, including:

• Deep vein thrombosis (DVT): Helps detect the presence of clots in the deep veins, usually in the legs or pelvis. Venography can provide detailed images to confirm the diagnosis when other methods, like ultrasound, do not yield definitive results.
• Chronic venous insufficiency: Assessing the functionality of venous valves and the degree of venous reflux that could lead to varicose veins and other complications.
• Varicose veins: Understanding the anatomy and function of veins in patients planning surgical or other treatments for varicose veins.
• Venous malformations: Diagnosing congenital or acquired vascular defects, providing a roadmap for possible interventions or surgeries.
• Pre-surgical evaluation: Assists in mapping venous anatomy before procedures like vein removal or endovenous laser therapy, ensuring precise surgical planning.
• Assessment of vein patency after procedures: Checking the patency of veins after surgical or other invasive procedures, such as angioplasty or stenting of the venous system.
• Superior vena cava syndrome: Evaluating obstruction (blockage) or compression of the superior vena cava, often due to tumors or thrombosis.
• Pelvic congestion syndrome: Diagnosing enlarged veins in the pelvis that may contribute to chronic pelvic pain.
• Portal hypertension: Helping to diagnose and assess complications such as varicose veins in the hepatic venous system due to increased pressure, often associated with liver cirrhosis.

Venography can provide comprehensive and detailed images of the venous system, aiding in diagnosis, planning therapeutic measures, and treatment of these conditions. While other non-invasive methods, such as Doppler ultrasound or MR venography, are often used early in the diagnostic process, venography may be indicated when these methods do not provide sufficient information.

Contraindications may include:

• Allergic reactions to iodine-based contrast materials.
• Severe kidney failure with impaired kidney function, as the use of contrast material may worsen the condition.
• Pregnancy—unless there is a compelling need for the procedure.

Diagnosis

To determine the necessity for venography, doctors commonly perform a thorough physical examination, review the medical history, and order imaging studies such as ultrasound or MR venography. A complete blood count (CBC) helps to identify signs of infection in the body, while other tests assist in determining underlying causes of venous disorders.

How the Procedure is Performed

Venography, also known as a venogram, typically takes 30 to 90 minutes, depending on the complexity of the procedure and the number of veins being examined. The process generally includes the following steps:

1. Preparation: Before the procedure, the patient may require a brief preparation period, including changing into hospital attire and discussing the procedure with medical staff. This may take 15 to 30 minutes.
2. Procedure: A catheter is inserted into a vein in the arm or foot, through which iodine-based contrast dye is injected, allowing the radiologist to take X-ray images of the veins. The physician will take a series of X-rays to capture the condition of the veins. The patient may be asked to change positions to obtain images from different angles.
3. Imaging Duration: The process of capturing images can last from 30 to 60 minutes.
4. After Completion: Once the procedure is finished, the catheter is removed, and a bandage may be placed at the injection site. The patient may be encouraged to rest and will be monitored for any immediate reactions to the contrast material or complications such as bruising or swelling at the injection site.

Recovery

The recovery process after venography includes post-procedural monitoring, with recommendations for hydration. Patients are encouraged to increase their fluid intake to help eliminate the contrast from their bodies more quickly.

The doctor will schedule a follow-up visit to discuss the results obtained from the venography and decide on further observation and/or treatment strategies.

Complications

The primary complications associated with venography can include allergic reactions to the contrast material, which can range from mild (hives, itching) to severe (anaphylactic shock). In patients with kidney dysfunction, the use of contrast agents may lead to further renal impairment. Rarely, infections may occur at the catheter insertion site or bleeding.

Prevention

To minimize the risk of complications related to venography, the following precautionary measures can be taken:

• Ensure that healthcare providers are aware of any known allergies to contrast materials or iodine before undergoing the procedure.

• Patients with diabetes, kidney disease, or other health issues should undergo kidney function assessment prior to the procedure to evaluate the risk of complications associated with the contrast material.
• Drinking plenty of fluids can help reduce the burden on the kidneys associated with the use of contrast and also facilitate its elimination from the body.
• Post-procedural monitoring: Patients should receive instructions on monitoring for any unusual symptoms after the procedure, such as swelling, pain at the injection site, or signs of infection, to enable timely medical intervention if necessary.

You can schedule a consultation through the form on our website or by contacting our center via phone.