Circulation, Vol 58, 898-902, Copyright © 1978 by American Heart Association
R Hull, DW Taylor, J Hirsh, DL Sackett, P Powers, AG Turpie and I Walker
We investigated the hypothesis that the diagnostic accuracy of impedance
plethysmography (IPG) for thrombosis of the popliteal or more proximal
veins increases with enhanced venous filling. Venous filling was increased
by prolonging cuff occlusion and by sequential testing. IPG and vengography
were performed on 169 legs with and 317 legs without proximal vein
thrombosis. The sensitivity and specificity of IPG rose significantly with
increased venous filling. Changes in venous filling were associated with
corresponding changes in emptying in normal legs, but not those with
proximal vein thrombosis, so that the regression lines relating venous
filling and emptying in normal and abnormal legs diverged significantly (P
less than 0.001). If the IPG sequence had been terminated after only a
single 45 second occlusion time test, sensitivity would have deteriorated
by 10% and specificity by 20%. These observations indicate that the
accuracy of IPG can be significantly enhanced if optimal venous filling is
obtained.
ARTICLES
Impedance plethysmography: the relationship between venous filling and sensitivity and specificity for proximal vein thrombosis
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