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Strain gauge plethysmography for the detection of deep venous thrombosis
S Croal1, J Birkmyre, M McNally
1Department of Orthopaedic Surgery, Queen's University of Belfast, N. Ireland.
Insights
A new non-invasive system for diagnosing deep venous thrombosis (DVT) shows high sensitivity. This strain gauge plethysmography method can reduce the need for costly and invasive venography, benefiting patients and clinicians.
Area of Science:
- Medical Devices
- Diagnostic Technology
- Vascular Medicine
Background:
- Deep venous thrombosis (DVT) causes significant morbidity and mortality.
- Current gold standard, venography, is invasive, costly, and often unnecessary.
- There is a need for accurate, non-invasive DVT diagnostic tools.
Purpose of the Study:
- To describe a novel, self-contained, non-invasive system for automatic venous occlusion plethysmography.
- To evaluate the diagnostic efficacy of strain gauge plethysmography for deep venous thrombosis.
- To develop and test an algorithm for discriminating between thrombotic and non-thrombotic limbs.
Main Methods:
- Strain gauge plethysmography was used to examine 274 symptomatic limbs.
- Results were compared with venography to develop a diagnostic algorithm.
- The system's efficacy was further tested on 101 symptomatic patients.
Main Results:
- Strain gauge plethysmography demonstrated 100% sensitivity and 66.3% specificity for proximal DVT in the initial study.
- In a subsequent group of 101 patients, the system achieved 94.7% sensitivity and 81.7% specificity for proximal thrombosis.
- The developed algorithm effectively discriminated between thrombotic and non-thrombotic limbs.
Conclusions:
- The Belfast DVT Screener, utilizing strain gauge plethysmography, is highly sensitive for diagnosing deep venous thrombosis.
- This non-invasive system can significantly reduce the reliance on venography.
- The technology offers benefits to both patients and clinicians by providing a more efficient and less invasive diagnostic pathway.
Abstract:
Deep venous thrombosis is a widely recognized medical problem which results in significant morbidity and mortality. Venography is the current 'gold standard' diagnostic test for deep venous thrombosis; however it is costly, invasive and is unnecessarily performed in 50% of cases. This paper describes a self-contained, non-invasive system for automatic venous occlusion plethysmographic measurement and analysis. An examination of 274 symptomatic limbs was conducted using strain gauge plethysmography and a subsequent venographic examination was then performed. The plethysmographic results were then compared with venography so as to develop a means of discrimination for thrombotic and non-thrombotic limbs. Strain gauge plethysmography using the Belfast DVT Screener yielded a sensitivity of 100% and a sensitivity of 66.3% for proximal segment DVT. The efficacy of the discriminatory algorithm was then tested for the diagnosis of DVT in a further 101 symptomatic patients. A sensitivity of 94.7% and a specificity of 81.7% were observed for strain gauge plethysmography for proximal segment thrombosis in this patient group. The Belfast DVT Screener is highly sensitive for deep venous thrombosis and may be used to reduce the need for venography, which is of benefit to both the patient and clinician.