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The Noninvasive Venous Vascular LaboratoryA Prospective Analysis
John C. Russell, MD;
Donald R. Becker, MD
Arch Surg. 1983;118(9):1024-1028.
Abstract
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• We undertook a prospective study to ascertain the accuracy of the noninvasive venous vascular laboratory in diagnosing clinically suspected deep-vein thrombosis. Of 88 patients studied with contrast venography and bilateral plethysmography, 41% had normal venograms; 15%, isolated venous thrombosis in the calf; and 44%, proximal deep-vein thrombosis. Clinical and Doppler examinations could not differentiate these three groups. The composite venous score was reliable at extreme values. By considering scores of 3.9 or less as negative, 8.0 or more as positive, and 4.0 to 7.9 as indeterminate, a suitable combination of sensitivity (75%), specificity (100%), and overall accuracy (90%) was obtained. Low-risk patients with scores of 3.9 or less should be observed. Patients with scores of 8.0 or greater can undergo anticoagulation without contrast venography, which is mandatory for patients with indeterminate venous scores and high-risk patients with scores of 3.9 or less.
(Arch Surg 1983;118:1024-1028)
Author Affiliations
From the Departments of Surgery, St Francis Hospital and Medical Center, Hartford, Conn, and the University of Connecticut School of Medicine, Farmington. Dr Russell is now with the Veterans Administration Medical Center, Newington, Conn, and the University of Connecticut School of Medicine, Farmington.
Footnotes
Accepted for publication April 4, 1983.
Read before the ninth annual meeting of the New England Society for Vascular Surgery, Bretton Woods, NH, Oct 15, 1982.
Reprint requests to Department of Surgery, St Francis Hospital and Medical Center, 114 Woodland St, Hartford, CT 06105 (Dr Becker).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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
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