Phlebography in the management of pulmonary embolism

The value of phlebography in the management of 102 patients presenting with clinical features suggestive of pulmonary embolism was assessed. Ascending phlebograms, chest x-rays and pulmonary perfusion scans were performed in all the cases. Of 33 patients with a high probability of pulmonary embolism, 29 (87 per cent) had thrombi in the peripheral veins shown by phlebography. Of 45 patients with no evidence of pulmonary emboli on lung scan, the deep veins were normal in 30, while in the remaining 15 (33 per cent), phlebograms showed the presence of thrombi. In all 7 patients where pulmonary angiography confirmed the presence of extensive emboli, phlebograms showed thrombi in the peripheral veins. Phlebography was of considerable help in deciding whether to give anticoagulant therapy.