A Simple Method for Lower Extremity Phlebography—Pseudo-Obstruction of the Popliteal Vein

Lack of consistent deep venous filling has been a shortcoming in phlebography of the lower extremity. Certain measures commonly adopted to improve phlebographic examination have included tourniquet placement about the ankle, internal rotation of the leg, serial filming, and biplane examination. The use of higher doses of contrast medium has been helpful only when the examination is performed in the erect position (3). Performance of the examination in the erect position is the only maneuver which has reportedly resulted in consistently good visualization of the deep venous system (4). This was pioneered by Lindblom (5), who felt that the poor visualization of the deep veins in the horizontal position was due to sedimentation of the contrast medium since it is heavier than blood. Greitz (3) showed that the effect was due to a lack of mixing rather than sedimentation and found that a position 65° from the horizontal was as successful as the vertical. Phlebography in the erect or semierect position is not wi...