It is invasive, and in patients with post- thrombotic iliac and caval lesions, it is typically done after US/CTV/MRV has characterized an occlusion or stenosis [9]. Catheter venography with IVUS is usually performed in those with an indication for venous intervention, such as iliac vein stenting typically after CTV or MRV has characterized an occlusion or stenosis [6,9]. Lower Extremity Chronic Venous Disease Catheter Venography Lower Extremity Venography is performed mostly during procedures with the intent on treating an iliac or IVC obstructive lesion. Collaterals and post thrombotic changes from stenoses and/or occlusions are typically noted. CTV Lower Extremity CTV of the lower extremity has not been cited as a first-line examination. However, it is very rarely used after duplex US in evaluation for occlusion, stenosis, collaterals, post-thrombotic changes, and axial transformation of the profunda vein [8]. Further highlighting the importance of CTV before intervention is the high rate of recurrence 2 years postintervention (15%-35%). Further anatomic characterization before therapy can ensure appropriate and effective treatment [10-13]. Understanding anatomy could aid in the selection of appropriate treatment modality and reduce recurrence and complication rates. In a study, retrospective evaluation of a prospectively acquired database, out of 810 studied limbs, there were numerous anatomic variations, including 1 anatomic variant that had not been described in the literature [11]. Characterization of these potential variants is important for treatment planning purposes. CTV Abdomen and Pelvis There are 2 scenarios described in the literature characterizing pelvic venous obstruction. Primary chronic venous disease describes a phenomenon in which there is obstruction in the pelvic or abdominal veins (eg, May-Thurner) without a prior DVT. Imaging can then be used to identify the cause of obstruction.
Lower Extremity Chronic Venous Disease. It is invasive, and in patients with post- thrombotic iliac and caval lesions, it is typically done after US/CTV/MRV has characterized an occlusion or stenosis [9]. Catheter venography with IVUS is usually performed in those with an indication for venous intervention, such as iliac vein stenting typically after CTV or MRV has characterized an occlusion or stenosis [6,9]. Lower Extremity Chronic Venous Disease Catheter Venography Lower Extremity Venography is performed mostly during procedures with the intent on treating an iliac or IVC obstructive lesion. Collaterals and post thrombotic changes from stenoses and/or occlusions are typically noted. CTV Lower Extremity CTV of the lower extremity has not been cited as a first-line examination. However, it is very rarely used after duplex US in evaluation for occlusion, stenosis, collaterals, post-thrombotic changes, and axial transformation of the profunda vein [8]. Further highlighting the importance of CTV before intervention is the high rate of recurrence 2 years postintervention (15%-35%). Further anatomic characterization before therapy can ensure appropriate and effective treatment [10-13]. Understanding anatomy could aid in the selection of appropriate treatment modality and reduce recurrence and complication rates. In a study, retrospective evaluation of a prospectively acquired database, out of 810 studied limbs, there were numerous anatomic variations, including 1 anatomic variant that had not been described in the literature [11]. Characterization of these potential variants is important for treatment planning purposes. CTV Abdomen and Pelvis There are 2 scenarios described in the literature characterizing pelvic venous obstruction. Primary chronic venous disease describes a phenomenon in which there is obstruction in the pelvic or abdominal veins (eg, May-Thurner) without a prior DVT. Imaging can then be used to identify the cause of obstruction.