Femoral Vein Occlusion Diagnosed by CT-Angiography in Patient with Great Saphenous Vein Incompetence

Abstract

Patient have been presented with the ulcers on the lateral and medial areas of the right ankle. Duplex scanning has revealed pathological reflux in the popliteal vein (about 6 seconds) and in the great saphenous vein (GSV) starting from the preterminal valve (about 3,5 seconds). The femoral vein could not be visualized. Bearing in mind that it is difficult to visualize the femoral vein in the Hunter canal, we undertook peripheral spiral computed angiography of the leg veins with the injection of the diluted contrast solution through the veins of the foot (according to the J. Uhl method). SCT angiography gave evidence of occlusion of the femoral vein and the presence of only two functional little branches of the deep veins. Great saphenous vein formed the important collateral pathway. For this reason, it was decided not to ablate it. The conservative treatment was successful and the ulcers were healed within 6 weeks. It is concluded that SCT-angiography of the lower leg veins with the injection of the contrast solution through the veins of the foot (as proposed by J. Uhl) can be used as an efficient method for the examination of the patients presenting with venous pathology in the lower extremities.