[Pitfalls in phlebography]. / Les pièges en phlébographie.

Despite the progress in functional investigation procedures, phlebography remains the standard test in venous disease of the lower extremities. The development of better quality contrast media has significantly improved patients tolerance. After a review of the regular, routine procedure, the authors stress the technic's pitfalls. Uncomplicated pitfalls are air bubbles, Venturi's effect, venous malformations, and superimposed venous axes or gases. This type of problems is easily circumvented. Flow images caused by confluent axes of high-flow veins (internal iliac veins, renal veins) or layer courants (gutter effect) are presented as a reminder. Compression images are often more treacherous: related to normal veins: compression of left iliac vein by aortic junction; of inferior vena cava by enlarged aorta or by osteophyte; tourniquet too low, iliac vein compressed by a dilated bladder; or compression due to intramuscular hematoma,... related to pathological veins: to be mentioned are bridle-caused obstruction of the popliteal vein (Klippel-Trénaunay syndrome), and retroperitoneal fibrosis. Although the present description of phlebography-related pitfalls is neither new, nor exhaustive, it should be reconsidered, as phlebography of the lower limbs, while being currently better tolerated, is still an update technic that needs to be rendered more reliable.

[Percutaneous angioscopy of the iliac and femoral arteries]. / L'angioscopie percutanée des artères iliaques et fémorales.

Very few papers about peripheral angioscopy are reported in literature. Percutaneous angioscopy (P.T.A.) of 25 peripheral arteries (21 iliac and 4 femoral arteries) have been performed by the authors without surgery and without anesthesia. Three observations are selected. The first one demonstrates an eccentric stenosis altering its diameter during pulsations; an irregular ulcerated atheroma is observed. The second case shows the signs of a centric atheroma with an intimal fragment. The last one is an intimal dissection due to PTA. The prospective aspects of this new technique are discussed.