qSpecialty Chair, Emory University Hospital, Atlanta, Georgia. rSpecialty Chair, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Lower Extremity Chronic Venous Disease of such lesions. However, there is no relevant literature regarding the use of catheter-directed venography of the iliac veins when evaluating for varicose veins. Catheter Venography Lower Extremity Catheter venography is ideal in performing descending venography of the lower extremity to evaluate for deep vein reflux [9]. However, there is no relevant literature regarding the use of catheter-directed lower extremity venography in the evaluation of bilateral GSV insufficiency with visible varicose veins. CTV Lower Extremity CT venography (CTV) of the lower extremity has not been cited as a first-line examination. However, given the high rate of recurrence 2 years postintervention (15%-35%), it has been suggested that further anatomic characterization before therapy can ensure appropriate and effective treatment [10-13]. Understanding the anatomy could aid in the appropriate selection of treatment, plan interventions, reduce recurrence, and decrease complication rates. In a study, a 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]. Limitations of this study include retrospective nature and possible selection bias given that it was a single center and consecutively acquired data. US has been championed as a best initial test.
Lower Extremity Chronic Venous Disease. qSpecialty Chair, Emory University Hospital, Atlanta, Georgia. rSpecialty Chair, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Lower Extremity Chronic Venous Disease of such lesions. However, there is no relevant literature regarding the use of catheter-directed venography of the iliac veins when evaluating for varicose veins. Catheter Venography Lower Extremity Catheter venography is ideal in performing descending venography of the lower extremity to evaluate for deep vein reflux [9]. However, there is no relevant literature regarding the use of catheter-directed lower extremity venography in the evaluation of bilateral GSV insufficiency with visible varicose veins. CTV Lower Extremity CT venography (CTV) of the lower extremity has not been cited as a first-line examination. However, given the high rate of recurrence 2 years postintervention (15%-35%), it has been suggested that further anatomic characterization before therapy can ensure appropriate and effective treatment [10-13]. Understanding the anatomy could aid in the appropriate selection of treatment, plan interventions, reduce recurrence, and decrease complication rates. In a study, a 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]. Limitations of this study include retrospective nature and possible selection bias given that it was a single center and consecutively acquired data. US has been championed as a best initial test.