Vascular-Laboratory Diagnosis of Clinically Suspected Acute Deep-Vein Thrombosis

Flanigan, D. Preston; Burnham, StevenJ.; Goodreau, JamesJ.; Bergan, JohnJ.; Yao, JamesS.T.

doi:10.1016/s0140-6736(78)92939-2

Cited by 66 publications

(25 citation statements)

References 8 publications

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“…The inclusion of con secutive patients and independent analysis of a standardized impedance plethysmography result with venography was used in 9 studies [13, [61][62][63][64][65][66][67][68], whereas the remaining 9 studies had a potential for bias, or did not truly evaluate accuracy [69][70][71][72][73][74][75][76][77], The combined analysis of the studies using proper methodol ogy demonstrated that impedance plethys mography detected 574 of the 639 proximal thrombi, for a sensitivity of 90% (table 5). False-positive results were obtained in 60 of the 1,352 patients, for a specificity of 96%.…”

Section: Impedance Plethysmographymentioning

confidence: 99%

“…The test result was falsely abnormal in 93 of the 706 patients without proximal-vein thrombosis, for a specificity of 87%. Conse- Other Methods An array of various methods including strain gauge plethysmography [82,93], liquid crystal (contact) thermography [94][95][96][97][98], light reflection rheography [99], computed tomog raphy scanning, and magnetic resonance scanning [100][101][102][103], radionuclide venography [104][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119][120][121][122][123], as well as numerous blood tests (including measurements of fibrinopeptide A [124,125], fibrin(ogen) degradation products (FDP) [126,127], degradation products of cross-linked fibrin (Z)-dimer) [128][129][130][131][132][133][134][135][136][137], pro thrombin fragments 1+2 (F I+2) and thro...…”

Section: Doppler Ultrasonographymentioning

confidence: 99%

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Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Cogo

Lensing²,

Wells³

et al. 1995

Pathophysiol Haemos Thromb

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Deep-vein thrombosis of the lower extremity is a frequent disorder associated with morbidity and mortality due to pulmonary embolism and the postthrombotic syndrome. It was not until the introduction of contrast venography that the inaccuracy of the clinical diagnosis became apparent. Since then, management decisions have usually been based on objective diagnostic test. Venography is generally considered the reference method for the diagnosis of deep-vein thrombosis, but it is invasive and associated with serious side effects. Several noninvasive or less invasive objective diagnostic methods have been developed. These diagnostic methods are distinctly different in technology and consequently in their ability to demonstrate or refute deep-vein thrombosis. In this review, a critical analysis is provided on the accurary of the current noninvasive diagnostic approaches to venous thrombosis in patients with a first episode of clinically suspected deep-vein thrombosis. Results of studies were considered only when their methodology fulfilled the essential criteria for evaluation of a diagnostic test.

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Section: Impedance Plethysmographymentioning

confidence: 99%

Section: Doppler Ultrasonographymentioning

confidence: 99%

Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Cogo

Lensing²,

Wells³

et al. 1995

Pathophysiol Haemos Thromb

View full text Add to dashboard Cite

show abstract

“…Conse quently an abnormal test result justifies the initia tion of anticoagulant treatment. Its sensitivity in calf vein thrombosis is considerably less (20%) because venous outflow may be possible through other patent calf veins; its specificity remains high at about 95% [16,[42][43][44][45][46][47][48][49],…”

Section: Mch Janssen Et Al / Netherlands Journal Ofmentioning

confidence: 99%

Diagnosis of deep vein thrombosis, an overview

Janssen

Wollersheim

Nováková

et al. 1996

The Netherlands Journal of Medicine

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A bstractBecause clinical signs and symptoms are unreliable the diagnosis of deep vein thrombosis (DVT) should be objectified. Advantages and disadvantages of contrast venography, plethysmography, ultrasound techniques, fibrino gen leg scanning, computer-assisted tomography, magnetic resonance imaging and blood tests are discussed. In patients with a first event of suspected DVT non-invasive methods like serial plethysmography or ultrasound testing are sensitive and specific enough to make a treatment decision. It is safe to withhold anticoagulants if the test remains normal within 1 week. In patients with suspected recurrent DVT new non-invasive techniques are being tested, but up to now the definitive objective diagnostic test continues to be contrast venography. In first period as well as in recurrent DVT D-Dimer testing could be an additional test to exclude active thromboembolism.

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“…[10][11][12] It is, however, invasive and expensive, often uncomfortable, not uniformly available, and not without morbidity; 9,[12][13][14] it also requires the services of experienced radiologists. 11,15 Because of these disadvantages, several non-invasive methods have been developed during the past decade, including 99 mTc-MAA ascending radionuclide venography, 16 125 I-fibrinogen test, 17,18 123 I-fibrinogen scintigraphy, 19 large-volume 99 mTc-pertechnetate radionuclide venography, 20,21 blood-pool radionuclide venography, [22][23][24][25][26] Doppler ultrasound, [27][28][29][30][31] real-time ultrasound, 32-39 impedance plethysmography, [40][41][42][43][44][45][46][47][48] and combined impedance plethysmography and 125I-fibrinogen leg scanning. 49,5 o All of these have their limitations.…”

Section: Introductionmentioning

confidence: 99%

Radionuclide venography of lower limbs by subcutaneous injection: Comparison with venography by intravenous injection

Jong

1989

Ann Nucl Med

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We have proved that subcutaneous injection (SC) of a small dose of Tc-99m pertechnetate (1 to 2 mCi: 37 to 74 MBq) at acupuncture points (K-3 and B-60) may offer an alternative method of radionuclide venography (RNV) of the lower limbs. In this study, we compared intravenous (IV) RNV and SC-RNV in 22 consecutive cases with typical signs and symptoms suggesting venous abnormality of the lower limb(s) from March to May 1988. They are 11 male and 11 female, aged 47.7 +/- 15.7 years. Among the 44 limbs of the 22 cases, 4 were normal, 12 (27.3%) were found to have varicose veins in the legs only, 18 (40.9%) had partial stenosis of the deep veins (14 poplito-tibial and 4 superficial femoral), and 13 (29.6%) had complete stenosis of the deep veins (4 poplitotibial, 1 superficial femoral and 8 ilio-femoral. SC-RNV showed almost the same results as IV-RNV in 21 (47.7%), superior to IV-RNV in 22 (50%) (including 4.6% failure of IV-RNV), and inferior to IV-RNV in 1 (2.3%). We conclude that SC-RNV is definitely an alternative method of lower-limb venography. Since it is in most cases superior to IV-RNV, we suggest that it can take the place of IV-RNV in routine work.

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Vascular-Laboratory Diagnosis of Clinically Suspected Acute Deep-Vein Thrombosis

Cited by 66 publications

References 8 publications

Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Diagnosis of deep vein thrombosis, an overview

Radionuclide venography of lower limbs by subcutaneous injection: Comparison with venography by intravenous injection

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