iothalamate-meglumine and Varicose-Veins

Topics: Adult; Clinical Trials as Topic; Contrast Media; Double-Blind Method; Female; Humans; Iodobenzoates; Iohexol; Iothalamate Meglumine; Male; Middle Aged; Phlebography; Thrombophlebitis; Triiodobenzoic Acids; Varicose Veins

A comparison was made of the incidence of venous thrombophlebitis resulting from the use of a high-osmolality contrast medium (Conray 60%, meglumine ioxaglate) and a low-osmolality contrast medium (Hexabrix 59%, meglumine iothalamate). In 30 patients with varicose veins, Conray was injected into one leg and Hexabrix into the other. The incidence of thrombophlebitis was then determined using the iodine-125 fibrinogen uptake test in a prospective, randomized, double-blind study. There was significantly less thrombophlebitis with Hexabrix than with Conray and the authors conclude that Hexabrix is safer for phlebography. Hexabrix is also stable in solution, only slightly more expensive than Conray, and one fifth the cost of metrizamide.

Topics: Adult; Aged; Clinical Trials as Topic; Contrast Media; Female; Fibrinogen; Humans; Iodine Radioisotopes; Iodobenzoates; Iothalamate Meglumine; Ioxaglic Acid; Leg; Male; Middle Aged; Radiography; Radionuclide Imaging; Thrombophlebitis; Triiodobenzoic Acids; Varicose Veins

Peroperative retrograde saphenography was used to study 80 incompetent long saphenous veins (LSV) in 60 patients with primary varicose veins. In 53 limbs presentation was uncomplicated (group A, 40 patients); in 27 limbs there was ulceration (group B, 20 patients). All limbs in group B had a normal deep system as shown pre-operatively by ascending and descending venography. Varicose changes were found in 52 (65 per cent) of 80 LSV; the overall mean length of normal vein seen was 16 cm. The incompetent LSV appears unlikely to be suitable for arterial replacement. All valves identified on operative saphenography above the knee appeared incompetent. In only 9 LSV of group B were there recognizable valves either above or below the knee, significantly fewer than 34 of group A (P less than 0.05). This finding suggests that a deficiency of saphenous valves may contribute to the development of venous ulceration. Hunterian perforators of variable size were seen on 70 saphenograms (87 per cent) passing directly from the LSV to the superficial femoral vein. Stripping of the incompetent LSV will disconnect such perforators from an incompetent system and may thus reduce the incidence of both recurrent varicose veins and persistent ulceration.

Topics: Female; Humans; Iothalamate Meglumine; Male; Middle Aged; Radiography; Saphenous Vein; Varicose Ulcer; Varicose Veins; Venous Insufficiency