Diagnostic Value of Lower Extremity Venous Duplication via Digital Subtraction Angiography Guided Venography

Vasc Endovascular Surg. 2024 Feb;58(2):166-171. doi: 10.1177/15385744231198355. Epub 2023 Aug 22.

Abstract

Introduction: Lower limb venous anomalies, including duplicated veins, are common and have significant impacts on the outcomes and efficacy of venous surgery. Digital subtraction angiography (DSA) guided venography, serving as the tertiary diagnostic option for venous disorders, offers valuable informations to clinical practitioners.

Patients and methods: A retrospective study was conducted on 195 patients with suspected venous disease, evaluating 259 limbs with venography imaging. Two experienced interventional vascularists evaluated the images to determine the incidence and characteristics of variances in the femoral, popliteal, great saphenous, and small saphenous veins. Moreover, blood samples were collected to assess the safety of the venography procedure by monitoring changes in renal function.

Result: Duplication variations were found in the lower limb veins, with the highest prevalence in the femoral vein (11.28%, 22/195), followed by the great saphenous vein (4.1%, 8/195), and the popliteal vein (1.54%, 3/195). No severe contrast agent allergies or postoperative complications were reported. No statistically significant differences were found in creatinine and urea levels pre- and post-operation for patients without duplication variations, those with duplication of the great saphenous, femoral, or popliteal vein (P < .05).

Conclusion: DSA-guided venography is effective in identifying venous variations in lower limb disease. DFV is the most common recurrent vein, while DPV is the least. Adequate preparation ensures safety, high spatial resolution, dynamic imaging, and low tissue interference.

Keywords: duplication; lower extremity vein variations; venography.

MeSH terms

  • Angiography, Digital Subtraction
  • Femoral Vein / diagnostic imaging
  • Humans
  • Lower Extremity / blood supply
  • Phlebography / methods
  • Retrospective Studies
  • Saphenous Vein / diagnostic imaging
  • Treatment Outcome
  • Vascular Diseases*
  • Venous Insufficiency*