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Does air plethysmography correlate with duplex scanning in patients with chronic venous insufficiency?
J Vasc Surg. 1993 Nov; 18(5):796-807.JV

Abstract

PURPOSE

Duplex ultrasonography with distal cuff deflation was used to determine the presence and size of incompetent veins and compare the results with those of air plethysmography in patients with chronic venous insufficiency.

METHODS

Thirty-two legs underwent a detailed study with both modalities. Sixteen legs had venous ulceration, six had stasis dermatitis, and ten had symptomatic varicose veins without skin changes.

RESULTS

Although the venous filling index (VFI) in limbs with ulcers (5.4 +/- 3.8 ml/sec) and dermatitis (7.7 +/- 4.6 ml/sec) was significantly higher (p < 0.05) than it was in limbs with varicose veins (2.6 +/- 1.7 ml/sec), there was a large amount of overlap. Only 13% of ulcerated legs had VFI greater than 10 ml/sec. Sixty-three percent of legs with ulcers, 33% of legs with dermatitis, and 90% of legs with varicose veins had VFIs less than 5 ml/sec. Mean ejection fractions (EFs) in the three groups were similar, ranging from 45% to 52%. Combining VFI and EF did not lessen the overlap between groups. Forty-one percent of limbs with ulcers or dermatitis had air plethysmography parameters in the normal or intermediate area (VFI < 5 ml/sec; EF > 40%), which in previous studies corresponded to an incidence of ulceration of only 2%. VFI had a significant but weak correlation (r = 0.39) with the diameter of incompetent veins at the knee and a somewhat stronger relationship (r = 0.55) with the diameter of lower leg veins. Total venous volume correlated moderately well with calf vein diameter (r = 0.75). The clinical status of the leg did not correlate with the diameters of incompetent veins at the knee or calf levels. All limbs with an obstructed outflow had EFs less than 60% and ulcers or dermatitis.

CONCLUSIONS

We conclude that plethysmographic measurements of functional venous parameters (VFI,EF) do not discriminate well between limbs with uncomplicated varicose veins and limbs with ulcers or stasis dermatitis and that VFI correlates poorly with the presence of incompetent veins and their diameters. Both duplex scanning and plethysmography seem to be necessary for a complete evaluation of limbs with chronic venous insufficiency.

Authors+Show Affiliations

Department of Surgery, Southern Illinois University School of Medicine, Springfield 62794-9230.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8230566

Citation

van Bemmelen, P S., et al. "Does Air Plethysmography Correlate With Duplex Scanning in Patients With Chronic Venous Insufficiency?" Journal of Vascular Surgery, vol. 18, no. 5, 1993, pp. 796-807.
van Bemmelen PS, Mattos MA, Hodgson KJ, et al. Does air plethysmography correlate with duplex scanning in patients with chronic venous insufficiency? J Vasc Surg. 1993;18(5):796-807.
van Bemmelen, P. S., Mattos, M. A., Hodgson, K. J., Barkmeier, L. D., Ramsey, D. E., Faught, W. E., & Sumner, D. S. (1993). Does air plethysmography correlate with duplex scanning in patients with chronic venous insufficiency? Journal of Vascular Surgery, 18(5), 796-807.
van Bemmelen PS, et al. Does Air Plethysmography Correlate With Duplex Scanning in Patients With Chronic Venous Insufficiency. J Vasc Surg. 1993;18(5):796-807. PubMed PMID: 8230566.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does air plethysmography correlate with duplex scanning in patients with chronic venous insufficiency? AU - van Bemmelen,P S, AU - Mattos,M A, AU - Hodgson,K J, AU - Barkmeier,L D, AU - Ramsey,D E, AU - Faught,W E, AU - Sumner,D S, PY - 1993/11/1/pubmed PY - 2001/9/6/medline PY - 1993/11/1/entrez SP - 796 EP - 807 JF - Journal of vascular surgery JO - J. Vasc. Surg. VL - 18 IS - 5 N2 - PURPOSE: Duplex ultrasonography with distal cuff deflation was used to determine the presence and size of incompetent veins and compare the results with those of air plethysmography in patients with chronic venous insufficiency. METHODS: Thirty-two legs underwent a detailed study with both modalities. Sixteen legs had venous ulceration, six had stasis dermatitis, and ten had symptomatic varicose veins without skin changes. RESULTS: Although the venous filling index (VFI) in limbs with ulcers (5.4 +/- 3.8 ml/sec) and dermatitis (7.7 +/- 4.6 ml/sec) was significantly higher (p < 0.05) than it was in limbs with varicose veins (2.6 +/- 1.7 ml/sec), there was a large amount of overlap. Only 13% of ulcerated legs had VFI greater than 10 ml/sec. Sixty-three percent of legs with ulcers, 33% of legs with dermatitis, and 90% of legs with varicose veins had VFIs less than 5 ml/sec. Mean ejection fractions (EFs) in the three groups were similar, ranging from 45% to 52%. Combining VFI and EF did not lessen the overlap between groups. Forty-one percent of limbs with ulcers or dermatitis had air plethysmography parameters in the normal or intermediate area (VFI < 5 ml/sec; EF > 40%), which in previous studies corresponded to an incidence of ulceration of only 2%. VFI had a significant but weak correlation (r = 0.39) with the diameter of incompetent veins at the knee and a somewhat stronger relationship (r = 0.55) with the diameter of lower leg veins. Total venous volume correlated moderately well with calf vein diameter (r = 0.75). The clinical status of the leg did not correlate with the diameters of incompetent veins at the knee or calf levels. All limbs with an obstructed outflow had EFs less than 60% and ulcers or dermatitis. CONCLUSIONS: We conclude that plethysmographic measurements of functional venous parameters (VFI,EF) do not discriminate well between limbs with uncomplicated varicose veins and limbs with ulcers or stasis dermatitis and that VFI correlates poorly with the presence of incompetent veins and their diameters. Both duplex scanning and plethysmography seem to be necessary for a complete evaluation of limbs with chronic venous insufficiency. SN - 0741-5214 UR - https://www.unboundmedicine.com/medline/citation/8230566/Does_air_plethysmography_correlate_with_duplex_scanning_in_patients_with_chronic_venous_insufficiency L2 - https://linkinghub.elsevier.com/retrieve/pii/0741-5214(93)90334-I DB - PRIME DP - Unbound Medicine ER -