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Serial impedance plethysmography for suspected deep venous thrombosis in outpatients. The Amsterdam General Practitioner Study.
N Engl J Med. 1986 Mar 27; 314(13):823-8.NEJM

Abstract

Diagnosis of deep venous thrombosis by clinical signs and symptoms is unreliable, but contrast venography is relatively expensive and invasive. We therefore evaluated the use of impedance plethysmography as a noninvasive alternative in 426 consecutive outpatients with clinically suspected acute deep venous thrombosis. Four sequential impedance plethysmograms were obtained on days 1, 2, 5, and 10 of the study. In 289 patients (68 percent), the results of all four studies were normal, and these patients were not treated with anticoagulants. One of these patients may have had a minor pulmonary embolus during the 10-day study period. During a six-month follow-up of all patients, none of the 289 patients whose plethysmograms were normal died of venous thromboembolism or presented with suspected pulmonary embolism. In 137 patients (32 percent), the impedance plethysmograms were abnormal; 117 (85 percent) had the abnormal results on their first test, and 20 (15 percent) had them on subsequent tests. All patients with abnormal plethysmograms also underwent contrast venography, which confirmed the diagnosis of deep venous thrombosis in 92 percent. We conclude that the diagnostic accuracy of repeated impedance plethysmography compares favorably with that of venography and that the technique is a safe and effective noninvasive approach to the diagnosis and care of outpatients with clinically suspected acute deep venous thrombosis.

Authors

Huisman MV
No affiliation info available
Büller HR
No affiliation info available
ten Cate JW
No affiliation info available
Vreeken J
No affiliation info available

MeSH

AdultAgedEvaluation Studies as TopicFemaleFollow-Up StudiesHumansMaleMiddle AgedPhlebographyPlethysmography, ImpedanceProspective StudiesPulmonary EmbolismThrombophlebitis

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

3951515

Citation

Huisman, M V., et al. "Serial Impedance Plethysmography for Suspected Deep Venous Thrombosis in Outpatients. the Amsterdam General Practitioner Study." The New England Journal of Medicine, vol. 314, no. 13, 1986, pp. 823-8.
Huisman MV, Büller HR, ten Cate JW, et al. Serial impedance plethysmography for suspected deep venous thrombosis in outpatients. The Amsterdam General Practitioner Study. N Engl J Med. 1986;314(13):823-8.
Huisman, M. V., Büller, H. R., ten Cate, J. W., & Vreeken, J. (1986). Serial impedance plethysmography for suspected deep venous thrombosis in outpatients. The Amsterdam General Practitioner Study. The New England Journal of Medicine, 314(13), 823-8.
Huisman MV, et al. Serial Impedance Plethysmography for Suspected Deep Venous Thrombosis in Outpatients. the Amsterdam General Practitioner Study. N Engl J Med. 1986 Mar 27;314(13):823-8. PubMed PMID: 3951515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serial impedance plethysmography for suspected deep venous thrombosis in outpatients. The Amsterdam General Practitioner Study. AU - Huisman,M V, AU - Büller,H R, AU - ten Cate,J W, AU - Vreeken,J, PY - 1986/3/27/pubmed PY - 1986/3/27/medline PY - 1986/3/27/entrez SP - 823 EP - 8 JF - The New England journal of medicine JO - N Engl J Med VL - 314 IS - 13 N2 - Diagnosis of deep venous thrombosis by clinical signs and symptoms is unreliable, but contrast venography is relatively expensive and invasive. We therefore evaluated the use of impedance plethysmography as a noninvasive alternative in 426 consecutive outpatients with clinically suspected acute deep venous thrombosis. Four sequential impedance plethysmograms were obtained on days 1, 2, 5, and 10 of the study. In 289 patients (68 percent), the results of all four studies were normal, and these patients were not treated with anticoagulants. One of these patients may have had a minor pulmonary embolus during the 10-day study period. During a six-month follow-up of all patients, none of the 289 patients whose plethysmograms were normal died of venous thromboembolism or presented with suspected pulmonary embolism. In 137 patients (32 percent), the impedance plethysmograms were abnormal; 117 (85 percent) had the abnormal results on their first test, and 20 (15 percent) had them on subsequent tests. All patients with abnormal plethysmograms also underwent contrast venography, which confirmed the diagnosis of deep venous thrombosis in 92 percent. We conclude that the diagnostic accuracy of repeated impedance plethysmography compares favorably with that of venography and that the technique is a safe and effective noninvasive approach to the diagnosis and care of outpatients with clinically suspected acute deep venous thrombosis. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/3951515/Serial_impedance_plethysmography_for_suspected_deep_venous_thrombosis_in_outpatients__The_Amsterdam_General_Practitioner_Study_ DB - PRIME DP - Unbound Medicine ER -