A New Computerized Impedance Plethysmograph: Accuracy in the Detection of Proximal Deep-Vein Thrombosis in Symptomatic Outpatients

Author:

Prandoni Paolo1,Lensing Anthonie W A12,Huisman Menno V2,Jonker Jan J C3,Vigo Mario4,Borm Judocus J J2,Büller Harry R2,Sing A K5,Carta Mariarosa1,Cate Jan Wouter ten2

Affiliation:

1. The Second Institute of Internal Medicine, Italy

2. The Center for Thrombosis, Haemostasis and Atherosclerosis Research, Academic Medical Center, Amsterdam, The Netherlands

3. The Thrombosis Service, Rotterdam, The Netherlands

4. The Department of Radiology, University Hospital of Padua, ltaly

5. The Department of Radiology, Bergweg Hospital, Rotterdam, The Netherlands

Abstract

SummaryBecause of the lack of specificity of the clinical diagnosis it is appropriate in patients with clinically suspected deep-vein thrombosis to apply an objective test before starting anticoagulant treatment. Impedance plethysmography is a highly accurate technique for the detection of proximal-vein thrombosis with a reported sensitivity and specificity of 93 and 97%, respectively. In all previous reported evaluations of impedance plethysmography an apparatus which was developed in 1971 was used.A new computerized impedance plethysmograph, using a novel device to measure impedance, was blindly compared against venography in 443 consecutive outpatients with clinically suspected deep-vein thrombosis. In the first phase of the study the computerized impedance plethysmography test results of 242 symptomatic patients were used to develop a discriminant line. Subsequently, this discriminant line was validated in the second phase of the study in another 201 symptomatic patients. The combined sensitivity and specificity of these two phases for proximal-vein thrombosis was 91% [95% confidence interval (Cl), 86 to 94%] and 94% (95% CI, 90 to 96%), respectively, which compares favourably with impedance plethysmography.It is concluded that computerized impedance plethysmography is a simple, portable, non-invasive technique with a high accuracy for the detection of proximal vein thrombosis. However, before computerized impedance plethysmography can be used as the only test in the diagnosis of deep-vein thrombosis, the safety of withholding anticoagulant treatment to patients with repeated normal computerized test results should be assessed during longterm follow-up studies.

Publisher

Georg Thieme Verlag KG

Subject

Hematology

Cited by 12 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Venous Thrombosis;Vascular Medicine;2006

2. The Diagnostic Approach to Acute Venous Thromboembolism;American Journal of Respiratory and Critical Care Medicine;1999-09

3. 2 Diagnostic management of venous thromboembolism;Baillière's Clinical Haematology;1998-09

4. A Practical Screener for Deep Vein Thrombosis after Total Hip Replacement;HIP International;1996-10

5. Diagnosis of deep vein thrombosis;Biomedicine & Pharmacotherapy;1996

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