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Prospective comparison of the pneumatic cuff and manual compression methods in diagnosing lower extremity venous
Stavros K Kakkos1, Judith C Lin, Jennifer Sparks
1Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
Aim:
To compare pneumatic cuff with manual compression in diagnosing reflux in patients with chronic venous insufficiency (CVI).
Patients And Methods:
Eighteen patients (Clinical Etiologic Anatomic Pathophysiologic [CEAP 2-5], median Venous Clinical Severity Score [VCSS 6.5]) were studied. The VenaPulse device (ACI Medical, San Marcos, California) was used for cuff inflation. The hemodynamic performance of the 2 methods was tested in the first 9 patients, while their diagnostic value was tested in the last 9 patients.
Results:
Both methods induced equal compression with median peak velocity of the antegrade flow (PVA) being 86 cm/s (P = .65). Coefficient of variation (CV) for PVA in the superficial veins was significantly higher with the manual method (16.8%) compared to the VenaPulse method (9.5%, P <.001), while sensitivity and specificity were 85% and 100%, and 78% (kappa .68, P <.001) and 100%, respectively.
Conclusions:
Pneumatic cuff and manual compression were shown to be equally effective in diagnosing venous reflux. Cost-effectiveness and ease-of-use studies comparing these methods are justified.
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