Phlebography as the Gold Standard in Thromboprophylactic Studies?

Recommendations from the ICM-VTE: General

“…Despite the fact that phlebography was considered to be the "gold standard" for diagnosis of DVT, the possibility of inadequate results (evaluation) when using this technique remains significant, reaching as high as 6 -20% [1066][1067][1068][1069] . Important points of concern include limited intra-and inter-observer agreement on venogra-phy results, as well as the lack of proper filling of the entire lower leg venous system (especially when injecting contrast into the foot vein for proximal deep vein segment visualization) [1069][1070][1071][1072][1073][1074][1075] .…”

Nontraumatic vascular emergencies: imaging and intervention in acute venous occlusion

“…Furthermore, venography may be nondiagnostic in up to 18% of cases through misinterpretations, artifacts, and interobserver disagreement [9]. Underfilling of vessels and vessel superposition are problems encountered especially in calf-vein phlebography.…”