Comparative value of noninvasive testing for diagnosis and surveillance of deep vein thrombosis

Journal Article · Fri Jan 01 04:00:00 EST 1988 · J. Vasc. Surg.; (United States)

DOI:https://doi.org/10.1067/mva.1988.avs0070040· OSTI ID:5410849

Comerota, A J; Katz, M L; Grossi, R J; White, J V; Czeredarczuk, M; Bowman, G; DeSai, S; Vujic, I

This is a prospective analysis of 351 patients in two distinct groups undergoing ascending phlebography, impedance plethysmography (IPG), and/or phleborheography (PRG) within the same 24-hour period. One hundred twenty patients also had a /sup 125/I-fibrinogen uptake test (RFUT). The two patient groups consisted of the following: those patients evaluated because of suspicion of deep vein thrombosis (DVT) (diagnostic) and those patients at high risk for postoperative DVT (total joint replacement) who had routine noninvasive testing and ascending phlebography (surveillance). The overall sensitivities for IPG and PRG were significantly better in the diagnosis group (71% (69 of 97 patients) and 78% (82 of 105), respectively) compared with the surveillance group (20% (14 of 71) and 27% (17 of 63), respectively) (p less than 0.0001). The sensitivities for IPG and PRG detecting proximal (A/K) thrombi was 83% (68 of 82 patients) and 92% (79 of 86) in the diagnosis group compared with 32% (11 of 34) and 33% (9 of 27) in the surveillance group (p less than 0.0001). Although there was no difference in overall incidence of DVT between the diagnosis group (56%, 118 of 212 patients) and the surveillance group (55%, 76 of 139), the results can be explained by the difference in A/K thrombi (84% (99 of 118) and 47% (36 of 76)) (p less than 0.001) and occlusive A/K thrombi (84% (58 of 69) and 23% (7 of 31)) (p less than 0.0001), respectively. Of the patients with A/K thrombi, 97% (67 of 69) in the diagnosis group had hemodynamically detectable thrombi compared with only 48% (12 of 25) in the surveillance group (p less than 0.001). Combining the RFUT with the noninvasive studies for surveillance significantly improved the sensitivity for both A/K and distal thrombi.

• Research Organization: Temple Univ. Hospital, Philadelphia, PA
• OSTI ID: 5410849
• Journal Information: J. Vasc. Surg.; (United States), Journal Name: J. Vasc. Surg.; (United States) Vol. 7:1; ISSN JVSUE
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BLOOD COAGULATION FACTORS
CARDIOVASCULAR DISEASES
COAGULANTS
COMPARATIVE EVALUATIONS
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
FIBRINOGEN
GLOBULINS
HEMATOLOGIC AGENTS
HEMOSTATICS
INTERMEDIATE MASS NUCLEI
IODINE 125
IODINE ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
MEDICINE
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
PATIENTS
PROTEINS
RADIOISOTOPES
RADIOLOGY
SENSITIVITY ANALYSIS
THROMBOSIS
TRACER TECHNIQUES
VASCULAR DISEASES