Non-invasive diagnostic techniques in deep vein thrombosis

1988 ◽  
Vol 50 ◽  
pp. 41-42
Author(s):  
H.R. Büller ◽  
J.W. ten Cate ◽  
M.V. Huisman, ◽  
A.W.A. Lensing ◽  
J.A. Hoek ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Diagnostic Techniques ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Deep Vein

Non-Invasive Diagnostic Techniques in Deep Vein Thrombosis

1990 ◽  
pp. 257-262
Author(s):  
D. P. M. Brandjes ◽  
H. R. Bueller ◽  
J. W. Cate ◽  
A. W. A. Lensing ◽  
G. C. F. M. Rutten ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Diagnostic Techniques ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Deep Vein

Diagnosis of Deep Vein Thrombosis by Combination of Doppler Ultrasound Flow Examination and Strain Gauge Plethysmography

1982 ◽  
Vol 47 (02) ◽  
pp. 141-144 ◽  
Author(s):  
H Bounameaux ◽  
B Krähenbühl ◽  
S Vukanovic
Keyword(s):  
Deep Vein Thrombosis ◽  
Negative Predictive Value ◽  
Doppler Ultrasound ◽  
Strain Gauge ◽  
Predictive Value ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Strain Gauge Plethysmography ◽  
Deep Vein

SummaryDoppler ultrasound flow examination, strain gauge plethysmography and contrast venography were performed in 160 lower limbs of 80 in-patients. Deep vein thrombosis (DVT) was suspected in 87 limbs. Using measurement of venous stop-flow pressure, the Doppler method had an overall sensitivity of 83%. By combined use of Doppler and Plethysmography, sensitivity was increased to 96%. Specificity was 62% and 51%, respectively. With a positive and a negative predictive value of 80% and 73%, respectively, the combination of both non-invasive methods cannot reliably replace venography in the diagnosis of DTV, although all (40/40) thromboses proximal to or involving the popliteal segment were detected by either Doppler and Plethysmography or both.After exclusion of 14 patients (18%) suffering from conditions known to alter the results of these non-invasive methods, the positive predictive value of abnormal findings in both Doppler and Plethysmography was increased to 94% for suspected limbs, whilst negative predictive value of both negative Doppler and Plethysmography was 90%, allowing the avoidance of venography in these patients.

Thermography and plethysmography, a non-invasive alternative to venography in the diagnosis of deep vein thrombosis

1990 ◽  
Vol 228 (1) ◽  
pp. 29-33 ◽  
Author(s):  
K. HOLMGREN ◽  
H. JACOBSSON ◽  
H. JOHNSSON ◽  
E. LÖFSJÖGÅRD-NILSSON
Keyword(s):  
Deep Vein Thrombosis ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Deep Vein

Diagnosis Of Deep Vein Thrombosis - “The Case for NonInvasive Testing”

1981 ◽  
Author(s):  
R Hull ◽  
J Hirsh
Keyword(s):  
Deep Vein Thrombosis ◽  
High Sensitivity ◽  
Cost Effective ◽  
Impedance Plethysmography ◽  
Noninvasive Testing ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Long Term Follow Up ◽  
Deep Vein ◽  
High Degree

Ascending venography, although the diagnostic standard for deep vein thrombosis (DVT), has important clinical pitfalls and shortcomings. It is invasive and thus not readily repeated: its use is associated with significant discomfort in many patients and in 3-4% of patients post-veno- graphic phlebitis is induced. A high degree of technical and interpretive skill is required and in up to 20% of patients routine ascending venography fails to visualize the external and common iliac veins. In many hospitals, outpatient access is not readily available necessitating admission to hospital for elective venography. Non-invasive testing with impedance plethysmography (IPG) is gaining increasing acceptance and use because it is objective, versatile and free of morbidity. IPG is sensitive and specific for symptomatic proximal DVT, but has the potential limitation that it is insensitive to calf DVT. Because of this, two different non-invasive approaches are currently advocated: a) serial IPG’s to detect calf vein thrombi which extend proximally (advocates of this approach suggest that calf DVT rarely lead to symptomatic pulmonary emboli unless proximal extension occurs) and b) addition of leg scanning to detect calf DVT. The effectiveness of serial IPG’s is uncertain and to resolve this issue we are currently performing a randomized trial. Multiple large studies however demonstrate that because of both high sensitivity and specificity, the combined approach of IPG and leg scanning provides a replacement for venography in the majority of symptomatic patients. Furthermore, the safety of witholding anticoagulant therapy in patients negative by combined IPG and leg scanning has been confirmed by long-term follow-up. Combined IPG and leg scanning is more cost-effective than elective venography because these non-invasive tests are readily performed in the emergency room or clinic, thus preventing unnecessary admission to hospital of patients with clinically suspected DVT who are negative by testing.

Non-invasive thrombolysis using microtripsy for deep vein thrombosis and intracerebral hemorrhage

2016 ◽  
Vol 140 (4) ◽  
pp. 3031-3031
Author(s):  
Zhen Xu ◽  
Xi Zhang ◽  
Jonathan Sukovich ◽  
Tyler I. Gerhardson ◽  
Hitinder Gurm ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Intracerebral Hemorrhage ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Deep Vein

The Diagnosis of Established Deep Vein Thrombosis

1979 ◽  
Author(s):  
R. Hull ◽  
J. Hirsh
Keyword(s):  
Deep Vein Thrombosis ◽  
Doppler Ultrasonography ◽  
Clinical Symptoms ◽  
Reference Method ◽  
Impedance Plethysmography ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Patient Morbidity ◽  
Low Sensitivity ◽  
Deep Vein

It is now generally accepted that the clinical diagnosis of deep venous thrombosis (DVT) is inaccurate both because of low sensitivity and specificity. Because more than 50% of symptomatic patients fail to show thrombi on venography, anticoagulant therapy on the basis of clinical symptoms of DVT is not acceptable. Venography has been the standard reference method for the diagnosis of DVT but is invasive and consequently associated with patient morbidity. Impedance plethysmography (IPG) and Doppler ultrasonography (Doppler) are both non-invasive and, in patients with clinically suspected DVT, are sensitive and specific tests for proximal DVT. Both tests are relatively insensitive to calf DVT. IPG has the advantage of being an objective technique whereas Doppler is subjective and its accuracy may suffer in inexperienced hands. 125I fibrinogen leg scanning (leg scanning) is an inappropriate test when used alone in patients with clinically suspected DVT as it is insensitive in the upper thigh, may be negative in 30% of patients with established DVT and may take up to 72 hours to become positive. The combination, however, of IPG and leg scanning provides an accurate approach for the detection of both proximal and calf DVT in patients with established DVT. This approach is not associated with patient morbidity and offers the clinician an alternative to venography.

Deep Vein Thrombosis: New Non-Invasive Diagnostic Tests

1991 ◽  
Vol 66 (01) ◽  
pp. 133-137 ◽  
Author(s):  
Harry R Büller ◽  
Anthonie WA Lensing ◽  
Jack Hirsh ◽  
Jan Wouter ten Cate
Keyword(s):  
Deep Vein Thrombosis ◽  
Diagnostic Tests ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Deep Vein

COMPUTERIZED IMPEDANCE PLETHYSMOGRAPHY, A NEW PLETHYSMOGRAPHIC METHOD TO DETECT DEEP VEIN THROMBOSIS

1987 ◽  
Author(s):  
P Prandoni ◽  
M Vigo ◽  
M V Huisman ◽  
J Jonker ◽  
H R Büller ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Discriminant Analysis ◽  
Impedance Plethysmography ◽  
Single Test ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Impedance Plethysmograph ◽  
Deep Vein ◽  
Center Study ◽  
Sensitive Method

Since the clinical diagnosis of deep vein thrombosis (DVT) is unreliable, several invasive and non-invasive methods have been developed recently. Of these, impedance plethysmography (IPG) is a widely employed technique based on measurement of changes in blood volume produced by temporary obstruction. IPG has been shovn in large prospective studies in symptomatic patients to be a safe and effective alternative to contrast venography, if used either in combination with 1251-fibrinogen legscanning or serially as a single test. Currently available impedance plethysmographs are limited by several technical and operational problems. Therefore, a new computerized impedance plethysmograph (CIP) was developed, having the following characteristics: portability, battery operated and fully automated. A prospective two-center study in 299 consecutive outpatients was done to compare the efficacy of CIP vs. venography in patients with symptomatic DVT. Using a blind design i.e. care was taken to insure that CIP and venography were performed and interpreted independently. The results in patients without venography proven thrombosis and those with proximal vein thrombosis were subjected to a discriminant analysis producing a line of best discrimination between normal and proximal vein thrombosis. In 14 patients it was not possible to obtain an adequate CIP tracing. 12 patients were not entered because of refusal to undergo venography and 15 patients were excluded from analysis because of poor opacification of the proximal veins. On the basis of discriminant analysis 138 of the CIP results were classified as normal and 120 as abnormal. 175 patients were normal on venography and 83 had proximal thrombosis. The sensitivity of CIP for proximal vein thrombosis was thus 95% while the speci-+ ficity was 77%. It is concluded that computerized impedance plethysmography is a potentially sensitive method to detect proximal vein thrombosis in patients with clinically suspected deep vein thrombosis.

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