metrizamide and Varicose-Veins

A high frequency of thrombotic complications of phlebography with conventional ionic contrast media has recently been reported by several writers. A switch to expensive non-ionic media has been recommended. Such a switch would undoubtedly place great restrictions on the use of this valuable procedure. In this prospective study two types of contrast media were compared. Only patients undergoing phlebography prior to operation for varicose veins and with no history of thrombotic disease were included. Post-phlebographic observations were made by microscopy of surgically removed vein specimens and by plethysmography. No significant difference emerged between the two groups of patients as regards thrombotic complications. A disadvantage of ionic media is their higher rate of immediate side-effects, such as pain. These effects, however, are clinically less important than the thrombotic complications, and they can be reduced by good phlebographic technique. In the authors' opinion, phlebography with ionic media remains justifiable, provided that the examination time is short and the dose and concentration of contrast medium are low.

Topics: Clinical Trials as Topic; Humans; Iodobenzoates; Leg; Metrizamide; Metrizoic Acid; Osmolar Concentration; Phlebography; Random Allocation; Thrombophlebitis; Varicose Veins

In contrast to the report by Albrechtsson, we have never seen clinically manifest thrombosis in more than 20,000 phlebographies; only small, clinically insignificant thrombi in a very few cases. The reason is because we have used only 40 cm3 of a 45% contrast medium in connection with heparin precaution. However, there is the possibility that the deep venous valves are damaged. Therefore Amipaque is important for the phlebography. Our test, 20 cm3 45% conventional contrast medium injected directly into varicose veins, always gives a venous thrombosis of about 20 cm. The same amount of Amipaque has never shown a reaction.

Topics: Diatrizoate; Humans; Leg; Metrizamide; Phlebography; Thrombophlebitis; Varicose Veins