Negative Phleborheography

Abstract

• Approximately 500,000 cases of pulmonary embolism appear each year in the United States, with most having clots that originated in the deep veins of the lower extremities. Since the clinical diagnosis of deep venous thrombosis (DVT) is accurate only half the time, a safe method that affords immediate and definitive diagnosis of DVT is urgently needed. One diagnostic technique now available is phleborheography (PRG). We examined 1,076 patients (2,152 limbs) during the period of 1976 to 1979. By performing PRG before hospital admission, 392 patients who had negative study results were not hospitalized, resulting in an estimated savings of $960,400 and avoiding both the hazardous treatment and the stigma associated with a diagnosis of DVT. After one to three years of follow-up in 593 patients (1,186 limbs) who had had negative results from PRG, only three (0.5%) have shown evidence of postphlebitic swelling and one (0.2%) has had pulmonary embolus. (Arch Surg 1981;116:795-797)