Mercury Strain-Gauge Plethysmography Venous Mode: Non-Invasive Technique of Choice in Vascular Pathology

1987 ◽  
Vol 2 (1) ◽  
pp. 47-51 ◽  
Author(s):  
J.P. Barroy ◽  
D. Munck ◽  
E. Paturiaux ◽  
M. Goldstein
Keyword(s):  
Strain Gauge ◽  
Venous Insufficiency ◽  
Venous Pressure ◽  
Vascular Pathology ◽  
Hysteresis Curve ◽  
Invasive Technique ◽  
Non Invasive ◽  
Strain Gauge Plethysmography ◽  
Precise Diagnosis ◽  
Mercury Strain Gauge

Mercury strain-gauge plethysmography venous mode is a non-invasive technique for exploration of the haemodynamics of the extremities. The plethysmographic parameters used are: (1) the venous inflow (in ml/100 ml/min); (2) the venous outflow (in ml/100 ml/min); (3) the venous capacity in ml/100ml; (4) the venous distensibility index in ml/100 ml/ mmHg; and (5) the venous pressure measured by ‘hysteresis curve’. This method permits us to analyse the venous haemodynamics of both extremities simultaneously (the normal limb serving as the control), to obtain a precise diagnosis and to appreciate the efficacy of treatment at follow-up. The aetiology of the swollen limb can be precisely identified in 95% of the studied cases: oedema in superficial venous insufficiency, oedema in the deep venous insufficiency, oedema of inflammatory origin, oedema in the arterial insufficiency, oedema of cardiac origin, lymphoedema. During the last 3 years, we have followed up 580 patients with this method.

Non-Invasive Measurement of Venous Muscle Pump Function in the Supine Position

1992 ◽  
Vol 7 (4) ◽  
pp. 146-149 ◽  
Author(s):  
H. J. L. van Gerwen ◽  
A. J. M. Brakkee ◽  
J. P. Kuiper
Keyword(s):  
Supine Position ◽  
Strain Gauge ◽  
Venous Pressure ◽  
University Hospital ◽  
Pressure Reduction ◽  
Pump Function ◽  
Muscle Pump ◽  
Non Invasive ◽  
Strain Gauge Plethysmography ◽  
Leg Movements

Objective: A new non-invasive procedure for testing venous muscle pump function in the horizontal position is presented. Design: The test is based on an indirect method we use for measuring ambulatory venous pressure by means of strain-gauge plethysmography. Setting: University Hospital Nijmegen, The Netherlands. Patients: The results of 28 limbs of 20 patients with deep venous insufficiency are compared with 32 limbs of 16 healthy volunteers. Interventions: The same test is performed in all patients and volunteers: in the supine position a raised venous pressure in the limb is induced by venous congestion. The reduction in venous volume after standardized leg movements is measured by strain-gauge plethysmography and, with an additionally obtained pressure-volume relation, this volume reduction is converted into a pressure reduction. Main outcome measure: The reduction by standardized leg movements of an increased venous pressure is a measure for calf muscle pump function. Results: The mean pressure reduction in the patient group was 47% (standard deviation (SD) = 8%), in the healthy group 77% (SD = 6%). Conclusions: The new ‘supine venous pump function test’ is a promising method for measuring the function of the deep veins. Since the whole procedure is performed in the horizontal positon, the method offers several important advantages.

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.

Non-invasive methods in the assessment of portal hypertension severity

2021 ◽  
Vol 75 (2) ◽  
pp. 125-133
Author(s):  
Soňa Franková ◽  
Jan Šperl
Keyword(s):  
Portal Hypertension ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Transient Elastography ◽  
Venous Pressure ◽  
Liver Stiffness ◽  
Invasive Technique ◽  
Hepatic Veins ◽  
Oesophageal Varices ◽  
Non Invasive

Portal hypertension represents a wide spectrum of complications of chronic liver diseases and may present by ascites, oesophageal varices, splenomegaly, hypersplenism, hepatorenal and hepatopulmonary syndrome or portopulmonary hypertension. Portal hypertension and its severity predicts the patient‘s prognosis: as an invasive technique, the portosystemic gradient (HPVG – hepatic venous pressure gradient) measurement by hepatic veins catheterisation has remained the gold standard of its assessment. A reliable, non-invasive method to assess the severity of portal hypertension is of paramount importance; the patients with clinically significant portal hypertension have a high risk of variceal bleeding and higher mortality. Recently, non-invasive methods enabling the assessment of liver stiffness have been introduced into clinical practice in hepatology. Not only may these methods substitute for liver biopsy, but they may also be used to assess the degree of liver fibrosis and predict the severity of portal hypertension. Nowadays, we can use the quantitative elastography (transient elastography, point shear-wave elastrography, 2D-shear-wave elastography) or magnetic resonance imaging. We may also assess the severity of portal hypertension based on the non-invasive markers of liver fibrosis (i.e. ELF test) or estimate clinically signifi cant portal hypertension using composite scores (LSPS – liver spleen stiff ness score), based on liver stiffness value, spleen diameter and platelet count. Spleen stiffness measurement is a new method that needs further prospective studies. The review describes current possibilities of the non-invasive assessment of portal hypertension and its severity.

scholarly journals Validation of the Supine Venous Pump Function Test: A New Non-Invasive Tool in the Assessment of Deep Venous Insufficiency

1996 ◽  
Vol 91 (4) ◽  
pp. 483-488 ◽  
Author(s):  
M. C. H. Janssen ◽  
J. A. H. R. Claassen ◽  
W. N. J. C. Van Asten ◽  
H. Wollersheim ◽  
M. J. M. De Rooij ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Normal Values ◽  
Venous Pressure ◽  
Calf Muscle ◽  
Pressure Measurements ◽  
Limits Of Agreement ◽  
Pump Function ◽  
Non Invasive ◽  
Calf Muscle Pump ◽  
Function Test

1. A new non-invasive test was developed to assess calf muscle pump function: the supine venous pump function test. The technique uses strain-gauge plethysmography and is performed in the supine position. The method is superior to other non-invasive methods because basically the most essential haemodynamic parameter, venous pressure decrease, is used by properly converting venous volume measurements into venous pressure. The validity of this test was established by comparison with invasive venous pressure measurements and by determining the reproducibility. Additionally, normal values were determined. 2. In 28 extremities the supine venous pump function test was performed simultaneously with invasive venous pressure measurements. The reproducibility of the test was assessed in 10 randomly chosen volunteers. In 34 volunteers normal values were obtained and 26 patients with clinical venous insufficiency were examined. 3. Comparison of the two methods revealed a correlation coefficient of r = 0.98 (P < 0.001). A mean difference of 3.9%pf between both methods was found with limits of agreement of − 6.3%pf to 14.1%pf. The coefficient of repeatability was 13%pf and the coefficient of variation was 9%. The normal range was found to be >60%pf. The mean pump function in the patient group was 45%pf. 4. The limits of agreement are small enough to be confident that the supine venous pump function test can be used instead of invasive venous pressure measurements to assess calf muscle pump function in clinical practice. The reproducibility of the test is good.

Changes in microvascular fluid filtration capacity during 120 days of 6° head-down tilt

2001 ◽  
Vol 91 (6) ◽  
pp. 2517-2522 ◽  
Author(s):  
F. Christ ◽  
J. Gamble ◽  
V. Baranov ◽  
A. Kotov ◽  
A. Chouker ◽  
...  
Keyword(s):  
Blood Flow ◽  
Water Permeability ◽  
Strain Gauge ◽  
Venous Pressure ◽  
Venous Congestion ◽  
Edema Formation ◽  
Fluid Filtration ◽  
Fluid Homeostasis ◽  
Strain Gauge Plethysmography ◽  
Filtration Capacity

We used venous congestion strain gauge plethysmography (VCP) to measure the changes in fluid filtration capacity ( K f), isovolumetric venous pressure (Pvi), and blood flow in six volunteers before, on the 118th day (D118) of head-down tilt (HDT), and 2 days after remobilization (Post). We hypothesized that 120 days of HDT cause significant micro- and macrovascular changes. We observed a significant increase in K f from 3.6 ± 0.4 × 10−3 to 5.7 ± 0.9 × 10−3ml · min−1 · 100 ml−1 · mmHg−1 (+51.4%; P < 0.003), which returned to pretilt values (4.0 + 0.4 × 10−3ml · min−1 · 100 ml−1 · mmHg−1) after remobilization. Similarly, Pvi increased from 13.4 ± 2.1 mmHg to 28.9 ± 2.8 mmHg (+105.8%; P < 0.001) at D118 and was not significantly different at Post (12.4 ± 2.6 mmHg). Blood flow decreased significantly from 2.3 ± 0.3 to 1.3 ± 0.2 ml · min−1 · 100 ml tissue−1 at D118 and was found elevated to 3.4 ± 0.7 ml · min−1 · 100 ml tissue−1at Post. We believe that the increased K f is caused by a higher microvascular water permeability. Because this may result in edema formation, it could contribute to the alterations in fluid homeostasis after exposure to microgravity.

The Relationship between Ultrasonic Ambulatory Venous Pressure and Residual Volume Fraction in Primary Venous Insufficiency

1999 ◽  
Vol 14 (4) ◽  
pp. 146-150
Author(s):  
P. Zamboni ◽  
D. Quaglio ◽  
C. Cisno ◽  
F. Marchetti ◽  
L. Cisno ◽  
...  
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Volume Fraction ◽  
Linear Regression Analysis ◽  
Venous Pressure ◽  
Lower Limbs ◽  
Residual Volume ◽  
Non Invasive ◽  
Vascular Laboratory ◽  
The Relationship

Objective: To study the relationship between two non-invasive methods for determining ambulatory venous pressure (AVP) in primary chronic venous insufficiency of the lower limbs. Design: Comparison between ultrasonic AVP (US-AVP) and residual volume fraction (RVF) determined by means of air plethysmography (APG). Setting: Department of Surgery and Vascular Laboratory, University of Ferrara, Italy. Patients: Twenty-one subjects affected by primary chronic venous insufficiency (CVI). Main outcome measure: A comparison of the AVP values extrapolated from the change in ultrasonic diameter of the saphenous vein after exercise and from RVF values. Ultrasonographic extrapolation was also made by the means of the software Venometer and compared with manual assessment. Results: Linear regression analysis demonstrated that US-AVP values were significantly correlated with RVF values ( r = 0.86 and p<0.0001). Assessment by Venometer as compared with manual calculation showed a high degree of correlation ( r = 0.98), p<0.0001). Conclusions: The two methods for non-invasive assessment of AVP appear to be closely and significantly correlated. The Venometer allows reliable and rapid extrapolation of AVP values.

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