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March 1953

ASCENDING ERECT PHLEBOGRAPHY: Management of Chronic Venous Insufficiency of Lower Extremity

Author Affiliations

Formerly at the Veterans Administration Hospital, Chamblee, Ga.; now at the Veterans Administration Hospital, Long Beach, Calif. (Dr. Smith).; From the Departments of Surgery and Radiology, the Veterans Administration Hospital, Chamblee, Ga., and the Emory University School of Medicine, Emory University, Ga.

AMA Arch Surg. 1953;66(3):292-300. doi:10.1001/archsurg.1953.01260030307004

THE MANAGEMENT of chronic venous insufficiency of the lower extremity, particularly the postphlebitic type, has been the subject of considerable discussion for several years and has in many instances proved to be a perplexing problem to the physician. The various forms of simple or extensive surgical procedures and of local conservative therapy which have been advocated are evidence of the fact that no one type of therapy is adequate in all cases.

A rational approach to the treatment of chronic venous insufficiency must include adequate knowledge of the status of the deep, communicating, and superficial venous systems, with reference to the patency of the venous channels and the competence of the valves. Past history and clinical examination may at times fail to provide an accurate evaluation of the venous return from the lower extremities. We have found ascending phlebography performed with the patient in the erect position to be of