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Related Experiment Videos

Screening for the potential pulmonary embolism victim.

J M Van de Water, K K Nelson, H W Kim

    The Journal of Cardiovascular Surgery
    |March 1, 1985
    PubMed
    Summary

    Bilateral impedance plethysmography accurately assesses deep venous obstruction. A two-second calf venous outflow of at least 65% indicates a patent system, aiding clinical decisions for anticoagulant therapy.

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    Area of Science:

    • Vascular Medicine
    • Diagnostic Imaging
    • Hemodynamics

    Background:

    • Deep venous obstruction is a significant clinical concern.
    • Accurate non-invasive diagnostic methods are crucial for timely treatment.
    • Venography, while definitive, is invasive and carries risks.

    Purpose of the Study:

    • To evaluate the diagnostic accuracy of bilateral impedance plethysmography (BIP) for detecting proximal deep venous obstruction.
    • To establish criteria using calf venous outflow and ventilatory changes for diagnosing venous obstruction.
    • To assess the utility of BIP in guiding anticoagulant therapy decisions.

    Main Methods:

    • Evaluated venous hemodynamics in 134 legs using a bilateral impedance plethysmograph.
    • Measured calf venous outflow after cuff release and calf volume changes during ventilation.

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  • Compared BIP results with venography findings.

    • Main Results:

    • An outflow of ≥65% in two seconds reliably indicated a patent deep venous system.
    • An outflow of ≤50% reliably indicated proximal deep venous obstruction.
    • For outflows between 50% and 65%, a ventilatory wave height >3 mm ruled out obstruction, while ≤3 mm was inconclusive.
    • The combined criteria achieved 92% accuracy, with no false negatives and a 10% false-positive rate.

    Conclusions:

    • Bilateral impedance plethysmography is a highly accurate, non-invasive method to rule out proximal deep venous obstruction.
    • The established criteria provide clinicians with confidence in initiating anticoagulant therapy for suspected cases.
    • This technique offers a valuable alternative to venography for evaluating deep venous system patency.