[Deep venous thrombosis of the lower extremity. Ultrasonography should replace phlebography as first line diagnostic imaging].

In Sweden, there is a widespread use of ascending venography for the diagnosis of deep vein thrombosis of the lower extremities (LEDVT) instead of ultrasonography. The main reason for this is the inferiority of US in diagnosing LEDVT in the calf veins. In order to indirectly estimate the magnitude of this inadequacy, we reviewed all of the cases of attempts to perform venograms at our center during a four-month period. The results showed that only 4-5 per cent of requested and successful venograms were able to show signs of LEDVT in the calf veins (distal LEDVT). With regards to these results and a recent report by SBU (Swedish Council on Technology Assessment in Health Care), we believe that US with compression technique and Doppler should be considered as a replacement for venography of the lower extremities as the first line of diagnostic imaging modality.