Surgical implications of saphenous venography

Abstract

Contrast material studies to assess the competence and patency of the deep venous system have been utilized frequently; and the radiographic technics and clinical application are well recognized. Emphasis on opacification of the superficial venous system, however, has not been described previously. Venography of the greater saphenous system with surgical implications in the reconstruction of small vessels, such as the femoropopliteal, coronary, and brachial arteries, has been found to be a valuable adjunct in the management of selected patients in my experience. Until the widespread adoption of the greater saphenous vein as the most suitable small vessel substitute, the main clinical significance attached to it was the frequent development of varicosities in the superficial venous system. Maximal utilization of the greater saphenous vein from the groin to the ankle is likely to become a necessity in some patients in whom portions of the vein have been removed already. Saphenous veins have also been used in the management of chronic venous insufficiency of the lower extremities [I]. The technic described here was indicated only in some selected patients in whom there was doubt concerning the availability of a suitable segment of saphenous vein, and in whom prosthetic bypass grafts could not be used with satisfactory results.