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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).

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