Bedside Screening for Venous Thrombosis Using Occlusive Impedance Phlebography

Hb, Wheeler; Ja, O'Donnell; Fa, Anderson; Bc, Penney; Ra, Peura; Benedict, Claude R.

doi:10.1177/000331977502600204

Cited by 33 publications

(4 citation statements)

References 8 publications

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“…The principle of impedance plethysmography (IPG) is based on the observation that blood volume changes in the calf, produced by maximum respiratory effort [44] or by inflation and deflation of a pneumatic thigh cuff [45], result in changes of electrical resistance (impedance). These changes are reduced in patients with thrombosis of the popliteal or more proximal veins.…”

Section: Plethysmographymentioning

confidence: 99%

“…A number of studies have evaluated IPG in patients with clinically suspected venous thromboembolism. Wheeler et al [45] compared results of IPG with venography in 168 legs. IPG was normal in 106 of 108 legs with normal venograms and abnormal in 40 of 41 legs with venographically demonstrated recent thrombi of the popliteal, femoral, or iliac veins (proximal vein thrombosis).…”

Section: Plethysmography As a Diagnostic Test For Clinically Suspecte...mentioning

confidence: 99%

“…Plethysmography is a noninvasive method for measuring venous outflow from the leg, and it has been used to diagnose venous thrombosis. Several plethysmographic techniques, including impedance plethysmography [42][43][44][45], strain-gauge plethysmography [46,47], and air-cuff plethysmography [48], have been used, but impedance plethysmography, introduced by Wheeler et al [44,45], has been most carefully evaluated. These techniques are sensitive to thrombosis of the popliteal, femoral, or iliac veins (proximal veins), but are relatively insensitive to calf vein thrombosis.…”

Section: Plethysmographymentioning

confidence: 99%

“…The original method, using maximum respiratory effort, had shortcomings because patients were often unable to cooperate sufficiently for the test to be reliable [49,50]. Therefore, the test was modified by using a pneumatic thigh cuff to temporarily occlude venous outflow [43,45].…”

Section: Plethysmographymentioning

confidence: 99%

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Comparative value of tests for the diagnosis of venous thrombosis

Hirsh

Hull

1978

World j. surg.

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The clinical diagnosis of venous thrombosis lacks sensitivity and specificity. Venography is recognized as the diagnostic reference standard but is invasive and associated with patient morbidity.125I‐fibrinogen leg scanning is sensitive to calf vein thrombosis but is relatively insensitive to femoral vein thrombosis and does not detect iliac vein thrombosis. This test is most useful as a screening test in high‐risk medical and surgical patients. The test may be falsely positive at the site of hematoma, and because of this, it has serious limitations in patients undergoing knee and hip surgery. Leg scanning also has limitations when used to diagnose patients with suspected venous thrombosis because it may take up to 72 hours to obtain a positive result. Impedance plethysmography (IPG), a noninvasive technique, is sensitive and specific for thrombosis involving the popliteal, femoral, and iliac veins. Combined with125Ifibrinogen leg scanning, this test has considerable potential as a screening test in patients undergoing hip surgery. The combined use of IPG and leg scanning has also been shown to be highly accurate for the diagnosis of clinically suspected venous thrombosis, and this approach offers a less invasive alternative to venography in these patients. The Doppler ultrasound flowmeter, like the IPG, is sensitive to popliteal and more proximal vein thrombosis but is relatively insensitive to calf vein thrombosis. The interpretation of the results of this test is more subjective and much more dependent upon the expertise of the examiner than is the IPG. A number of other techniques, including image scanning, and themography, are under investigation but require further evaluation before they can be recommended in the management of patients with venous thromboembolism.

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Section: Plethysmographymentioning

confidence: 99%

Section: Plethysmography As a Diagnostic Test For Clinically Suspecte...mentioning

confidence: 99%