This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Management by Impedance Plethysmography

H. Brownell Wheeler, MD; Frederick A. Anderson, Jr, MS; Paul A. Cardullo, BSN; Nilima A. Patwardhan, MD; Li Jian-Ming, MD; Bruce S. Cutler, MD

Arch Surg. 1982;117(9):1206-1209.

Abstract
• Controversy exists as to whether patients suspected of having deep vein thrombosis (DVT) can be studied safely without venography, with its attendant expense, inconvenience, and potential risk. We used impedance plethysmography (IPG) in 1,464 consecutive patients suspected of having DVT, with 96% of these patients being managed without venography. In 1,074 patients with normal IPGs, there were no fatal pulmonary emboli (PE). The incidence of nonfatal PE was 1%. In 284 outpatients suspected of having DVT, but discharged without treatment because of normal IPGs, only one patient returned with subsequent symptoms of DVT (0.4%). Noninvasive testing with IPG is a safe and highly cost-effective alternative to venography for routine management of patients suspected of DVT.

(Arch Surg 1982;117:1206-1209)

Author Affiliations
From the Department of Surgery, University of Massachusetts Medical School, Worcester.

Footnotes
Accepted for publication April 20, 1982.

Read before the eighth annual meeting of the New England Society for Vascular Surgery, Waterville Valley, NH, Sept 25, 1981.

Reprint requests to Department of Surgery, University of Massachusetts Medical School, Worcester, MA 01605 (Dr Wheeler).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Pulmonary Embolism and Pulmonary Thromboendarterectomy
Madani and Jamieson
Card Surg Adult 2008;3:1309-1332.
FULL TEXT  

Risk Factors for Venous Thromboembolism
Anderson and Spencer
Circulation 2003;107:I-9-16.
ABSTRACT | FULL TEXT  

Pulmonary Thromboendarterectomy
Madani and Jamieson
Card Surg Adult 2003;2:1205-1228.
FULL TEXT  

Management of Deep Vein Thrombosis and Pulmonary Embolism : A Statement for Healthcare Professionals From the Council on Thrombosis (in Consultation With the Council on Cardiovascular Radiology), American Heart Association
Hirsh and Hoak
Circulation 1996;93:2212-2245.
FULL TEXT  

Diagnostic Tests for Deep Vein Thrombosis: Clinical Usefulness Depends on Probability of Disease
Wheeler et al.
Arch Intern Med 1994;154:1921-1928.
ABSTRACT  

A Comparison of Real-Time Compression Ultrasonography with Impedance Plethysmography for the Diagnosis of Deep-Vein Thrombosis in Symptomatic Outpatients
Heijboer et al.
NEJM 1993;329:1365-1369.
ABSTRACT | FULL TEXT  

When Can Treatment Be Withheld in Patients With Suspected Pulmonary Embolism?
Dalen
Arch Intern Med 1993;153:1415-1418.
ABSTRACT  

Diagnosis of Deep Vein Thrombosis: Using the Right Test for the Right Purpose
Wheeler
Arch Intern Med 1991;151:2145-2146.
ABSTRACT  

Ambulatory Management of Suspected Deep Vein Thrombosis
WHEELER
Arch Intern Med 1989;149:501-502.
ABSTRACT  

Shortcomings of Physical Examination and Impedance Plethysmography in the Diagnosis of Lower Extremity Deep Venous Thrombosis
Vaccaro et al.
ANGIOLOGY 1987;38:232-235.
ABSTRACT  

The Clinical Implications of Bilaterally Abnormal Impedance Plethysmography
Curley et al.
Arch Intern Med 1987;147:125-129.
ABSTRACT  

Expanded Criteria for the Diagnosis of Deep Venous Thrombosis: Use of the Pulse Volume Recorder and Doppler Ultrasonography
Howe et al.
Arch Surg 1984;119:1167-1170.
ABSTRACT  

The Noninvasive Venous Vascular Laboratory: A Prospective Analysis
Russell and Becker
Arch Surg 1983;118:1024-1028.
ABSTRACT