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A Journal on Internal Medicine

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Frequency: Quarterly

ISSN 0031-0808

Online ISSN 1827-1898


Panminerva Medica 2001 June;43(2):69-75


Upper extremities deep venous thrombosis: comparison of light reflection rheography and colour duplex ultrasonography for diagnosis and follow-up

Petrakis I. E., Sciacca V., Katsamouris A. N. *

From the 1st Department of General Surgery “Policlinico Umberto I” University of Rome “La Sapienza”, Rome, Italy
*Division of Vascular Surgery University Hospital of Herakleion University of Crete, Crete, Greece

Background. Non-inva­sive diag­no­sis of axil­lary-sub­cla­vian ­vein throm­bo­sis or doc­u­men­ta­tion of the ­post-throm­bot­ic syn­drome per­form­ing meth­ods cur­rent­ly in use is not defin­i­tive. The pur­pose of ­this pros­pec­tive ­study was to com­pare two meth­ods for the diag­no­sis and fol­low-up of ­patients ­with pri­mary and sec­on­dary axil­lary-sub­cla­vian ­vein throm­bo­sis: ­light reflec­tion rhe­og­ra­phy (LLR) ­which is a reflec­tion of ­venous pres­sure chang­es in the extrem­ity as ­record ­from the sub­der­mal cap­il­lary plex­us, and ­colour ­duplex ultra­so­nog­ra­phy (­CDUS).
Methods. In 36 ­patients ­with pri­mary and sec­on­dary axil­lary-sub­cla­vian ­vein throm­bo­sis ­were ­used a 4006 GE (Milwaukee, USA) ­colour ­duplex ultra­so­nog­ra­phy and an AV-1000 Hemodynamics instru­ment for the ­light reflec­tion rhe­og­ra­phy for diag­no­sis and fol­low-up. The LLR meth­o­dol­o­gy ­that ­applied was sim­ple, involv­ing test­ing of the ­venous out­flow in the ­upper extrem­ities in ­response to exer­cise, and ­with nor­mal­ly res­pir­a­to­ry vari­a­tions of an ­open ­venous ­system ­that was ­also ­assessed by the non-inva­sive modal­ities. In the LLR appli­ca­tion of ­venous con­gest­ing pres­sure, and meas­ure­ment of the ­rate of ­venous out­flow ­when the con­gest­ing pres­sure is ­released was ­also per­formed.
Results. Both meth­ods ­were ­able to diag­nose the axil­lary-sub­cla­vian throm­bo­sis in the ­initial ­acute ­state. There ­were no cas­es of ­false-pos­i­tive ­results in ­either meth­od. The ­CDUS pre­sent­ed a low­er sen­si­tiv­ity in com­par­i­son to LLR in the fol­low-up peri­od of the ­patients. A pos­i­tive ­study was con­firmed by phle­bog­ra­phy in ­each ­instance.
Conclusions. The trac­ing ­obtained by LLR is ­easy to inter­pret and pro­vides objec­tive evi­dence of prox­i­mal ­venous occlu­sion. The ­test is ­easy to ­apply and the instru­men­ta­tion is rel­a­tive­ly inex­pen­sive. Both LLR and ­CDUS, ­could ­prove to be an excit­ing devel­op­ment ­among non inva­sive diag­nos­tic tech­niques for axil­lary-sub­cla­vian ­vein throm­bo­sis, ­with ­major sen­si­tiv­ity of LLR in the fol­low-up.

language: English


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