[Study of the veins of the foot by counter-current phlebography].

83 CF phlebographies of the foot veins were carried out in varicose vein sufferers of both sexes in order to better understand the return venous circulation of the foot in detail, its abnormalities, and also to attempt to explain edema of the foot suffered by many varicose vein patients to varying degrees of severity after saphenous stripping. Films were obtained by direct needle puncture at different sites on the fore-foot, after a tourniquet was placed around the ankle. The route taken by the contrast medium injected was followed on a fluoroscop screen and photographed. Images obtained were classified under 4 headings: 1) slight, 2) moderate, 3) loaded and 4) overloaded opacification. In normal or slightly pathological cases (group 1 and 2), contrast medium was evacuated via a route ranging from level 1 (superficial) to level 3 (deep), this being the "usual evacuation circuit." In frankly pathological cases (groups 3 and 4), a "subsidiary evacuation circuit" may develop. It is also possible that after a degree of stagnation (by obstruction of the main veins of the foot) the contrast medium is very slowly evacuated by a number of small collateral veins. Edema of the foot as seen in some varicose vein patients as well as that which occurs post-operatively in the majority of patients undergoing varicose vein surgery is felt to be more often due to valve incompetence and to hypotonicity of the venous walls rather than to thrombosis of a deep vein of the foot.