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Lower limb contrast venography: a modified technique for use in thromboprophylaxis clinical trials for the accurate evaluation of deep vein thrombosis

¹ Department of Radiology, King's College Hospital, ² Department of Haematology, John Radcliffe Hospital, Oxford, UK

View larger version (93K): [in this window] [in a new window]   Figure 1. Antegrade cannulation in the dorsum of the left foot and dorsum of the right great toe. A Foley catheter is shownin situ above the left malleolus with a tourniquet above the left knee.

View larger version (99K): [in this window] [in a new window]   Figure 2. Fluoroscopy table tilted to 30° with contrast injected by the assistant who also compresses the calf prior to the tilting the table into the horizontal position.

View larger version (109K): [in this window] [in a new window]   Figure 3. Venography images of the upper calf in three separate views: (a) neutral position; (b) internal rotation; and (c) external rotation.

View larger version (129K): [in this window] [in a new window]   Figure 4. Venography images of the popliteal fossa of a patient with a total knee replacement: (a) neutral position; and (b) external rotation.

View larger version (126K): [in this window] [in a new window]   Figure 5. Venography images of the common iliac vein and inferior vena cava. The image intensifier is placed over the abdomen and the remaining 15 ml of contrast injected as a fast bolus, while the calf is gently squeezed and the lower leg elevated.