Serial Impedance Plethysmography for Diagnosis of Symptomatic Venous Thrombosis

1986 ◽  
Vol 315 (12) ◽  
pp. 765-765 ◽  
Keyword(s):  
Venous Thrombosis ◽  
Impedance Plethysmography

Is Quantitative Determination of Fibrin(ogen) Degradation Products and Thrombin-Antithrombin III Complexes Useful to Diagnose Deep Venous Thrombosis in Outpatients?

1989 ◽  
Vol 62 (04) ◽  
pp. 1043-1045 ◽  
Author(s):  
Paul F M M van Bergen ◽  
Eduard A R Knot ◽  
Jan J C Jonker ◽  
Auke C de Boer ◽  
Moniek P M de Maat
Keyword(s):  
Quantitative Determination ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Antithrombin Iii ◽  
Degradation Products ◽  
Family Doctor ◽  
Diagnostic Value ◽  
Impedance Plethysmography ◽  
Fibrin Degradation Products

SummaryWe studied the diagnostic value of recently introduced ELISA’s for the determination of thrombin-antithrombin III (TAT) complexes, fibrin degradation products (FbDP), fibrinogen degradation products (FgDP) and total degradation products (TDP) for deep venous thrombosis (DVT) in plasma of 239 consecutive outpatients, suspected for DVT by their family doctor. DVT was confirmed by impedance plethysmography in 60 patients. Using the 95th percentile range of 42 healthy volunteers the sensitivity for the detection of DVT was: 37% for TAT, 95% for TDP, 92% for FbDP and 90% for FgDP. Specificity was: 88% for TAT, 16% for TDP, 20% for FbDP and 25% for FgDP.We conclude that these assays are of little value in the diagnosis of DVT in outpatients.

Silent Venous Thrombosis Revealed by Impedance and 125I-Fibrinogen

1975 ◽  
Author(s):  
M. Hume
Keyword(s):  
At Risk ◽  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Clinical Significance ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Clinical Evidence ◽  
Impedance Plethysmography ◽  
Patients At Risk ◽  
Lung Scan

100 post-operative subjects were observed following total hip replacement using 125I-fibrinogen (125I-Fg) and impedance plethysmography (IPG) with thigh cuff. Phlebo-grams were obtained if these tests indicated venous thrombosis. Also, lung scan was obtained if clinical evidence of pulmonary embolism developed. Sustained significant isotope localization occurred in 40. 32 of these had abnormal IPG. Four patients had minor pulmonary embolism, which was associated with abnormality of either 125I-Fg or IPG. All major obstructive venous thrombosis and all moderately extensive thrombosis was associated with abnormal IPG. Only minute thrombi were not correctly classified by IPG. The following conclusions are supported by this experience. 1) If prospectively applied in patients at risk, the combination of both techniques (125I-Fg, IPG) is capable of detecting all silent venous thrombosis even minute thrombi of negligible significance. 2) IPG is capable of detecting all major obstructive and all moderately extensive thrombi, that is, all thrombosis of clinical significance arising in the leg. 3) Minute thrombi will not be detected by IPG alone and small emboli resulting from detachment of such minute thrombi would be unheralded unless monitoring includes 125I-Fg.

Shortcomings of Physical Examination and Impedance Plethysmography in the Diagnosis of Lower Extremity Deep Venous Thrombosis

Angiology ◽  
1987 ◽  
Vol 38 (3) ◽  
pp. 232-235 ◽  
Author(s):  
Patrick Vaccaro ◽  
Michael Van Aman ◽  
Susan Miller ◽  
Jacque Fachman ◽  
William L. Smead
Keyword(s):  
Lower Extremity ◽  
Physical Examination ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Impedance Plethysmography

Failure of Computerized Impedance Plethysmography in the Diagnostic Management of Patients with Clinically Suspected Deep-Vein Thrombosis

1991 ◽  
Vol 65 (03) ◽  
pp. 233-236 ◽  
Author(s):  
P Prandoni ◽  
A W A Lensing ◽  
H R Büller ◽  
M Carta ◽  
M Vigo ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Clinical Medicine ◽  
Impedance Plethysmography ◽  
Diagnostic Modality ◽  
Vein Thrombosis ◽  
Diagnostic Management ◽  
Lower Ability ◽  
Abnormal Test Result ◽  
Deep Vein

SummaryBefore a new diagnostic modality can be introduced in clinical medicine, the validity of both a normal and abnormal test result have to be assessed prospectively in an appropriate patient group. We have evaluated the clinical validity of. a new computerized impedance plethysmography (CIP) in the diagnostic management of 381 consecutive patients with clinically suspected venous thrombosis. In patients with serially normal CIP results, the diagnosis of venous thrombosis was refuted and, consequently, they were not treated with anticoagulant therapy and all were followed up for a period of 6 months to estimate the occurrence of symptomatic venous thromboembolism.The study was prematurely terminated by the safety monitoring committee because of an unacceptably high incidence of confirmed venous thromboembolism (10 patients, 3.2%; 95% confidence interval: 1.6% to 6%), including 4 episodes of fatal pulmonary embolism. In a subsequent explanatory study using ultrasonography in 29 other symptomatic patients who had at least 2 repeated normal CIP test results, the failure of CIP to detect proximal vein thrombosis was confirmed in 4 patients (14%). The reasons for this failure are probably related to the use of a modified device to measure impedance in the CIP apparatus, resulting in a lower ability to separate patients without venous thrombosis from those with the disease.We concluded that CIP is insensitive for the detection of proximal vein thrombosis and, therefore, not clinically useful in the diagnostic management of patients with suspected venous thrombosis.

An Evaluation of Impedance Plethysmography and 125I-Fibrinogen Leg Scanning in Patients following Hip Surgery

1989 ◽  
Vol 62 (03) ◽  
pp. 830-834 ◽  
Author(s):  
M K Cruickshank ◽  
M N Levine ◽  
J Hirsh ◽  
A G G Turpie ◽  
P Powers ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Venous Thrombosis ◽  
Sensitivity And Specificity ◽  
Patient Management ◽  
Outcome Measure ◽  
Impedance Plethysmography ◽  
Hip Surgery ◽  
Screening Tests ◽  
Non Invasive ◽  
Combined Use

SummaryVenous thromboembolism is a common post-operative complication in patients following hip surgery. 125I-fibrinogen leg scanning and impedance plethysmography (IPG), are often used in the detection of venous thrombi in such patients. Information on the sensitivity and specificity of these non-invasive tests for the diagnosis of venous thrombosis following hip surgery is relevant for both patient management and for choosing the appropriate outcome measure for clinical trials evaluating new prophylactic regimens.We determined the sensitivity and specificity of the IPG alone, the 125I-fibrinogen leg scan alone, as well as the combined use of the two tests from a retrospective analysis of 685 hip surgery patients who participated in clinical trials of anti-thrombotic prophylaxis. These patients were followed prospectively with non-invasive tests. Bilateral venography was attempted either when one or both screening tests became positive or on day 10-14 post-operatively if both screening tests remained negative. Adequate venography was obtained in 1,010 (73.7%) legs and thrombi were identified in 198 (19.6%) legs.The sensitivities of the IPG and leg scanning were 12.9% and 44.6% respectively; the corresponding specificities were 98.1% and 95.0%. The sensitivity of a positive result on one or both screening tests was 49.6% with a specificity of 93.9%.Therefore, leg scanning and IPG, even in combination, are not sufficiently accurate to be recommended as the only strategy for the diagnosis of venous thrombosis following hip surgery. Venography should be considered in all patients undergoing surveillance testing either when one or both of the screening tests become positive or on day 10-14 if the screening tests remain negative.

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