Cuff-impedance phlebography and 125I fibrinogen scanning versus roentgenographic phlebography for diagnosis of thrombophlebitis following hip surgery. A preliminary report

Wh, Harris; Athanasoulis, Christos A.; Ac, Waltman; Ew, Salzman

doi:10.2106/00004623-197658070-00008

Cited by 61 publications

(14 citation statements)

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“…On these bases for almost 20 years, leg scanning has been the accepted standard for the diag nostic screening for deep vein thrombosis for clinical practice and for clinical trials on the evaluation of pharmacological agents for pro phylaxis of deep vein thrombosis. The accura cy of leg scanning has been challenged by the results of more recent studies which reported a low sensitivity for calf vein thrombosis in high-risk patients undergoing hip surgery [6,7,[19][20][21][22][23][24]. In order to explain the relatively poor sensitivity of leg scanning in contempo rary studies, Lensing and Hirsh [25] have per formed a critical review of all publications in which this diagnostic technique was used to screen postoperative deep vein thrombosis in orthopedic or general surgery patients.…”

Section: L-fibrinogen Leg Scanningmentioning

confidence: 99%

Diagnosis of Deep Vein Thrombosis in Asymptomatic High-Risk Patients

Agnelli¹,

Radicchia²,

Nenci³

1995

Pathophysiol Haemos Thromb

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Postoperative deep vein thrombosis is usually asymptomatic so that pulmonary embolism is often the first clinical manifestation of venous thromboembolism. The diagnostic accuracy of impedance plethysmography, ¹²⁵I-fibrinogen leg scanning and real-time B-mode ultrasonography has been extensively evaluated in patients with asymptomatic deep vein thrombosis. Impedance plethysmography has been evaluated in a number of studies and its sensitivity has been invariably found to be approximately 20% or less. These results seem to be due to the high prevalence in asymptomatic patients of distal, small and nonocclusive thrombi, unable to produce a critical obstruction of the venous flow. The accuracy of ¹²⁵I-fibrinogen leg scanning has been assessed in a number of studies and found to be significantly different in the initial and more recent studies. This difference has been found to be due to the quality of the study design: the better the methodology, the lower the diagnostic accuracy of ¹²⁵I-fibrinogen leg scanning. The association of impedance plethysmography and ¹²⁵I-fibrinogen leg scanning do not result in an improvement of the results obtained by the single diagnostic method. Study methodology strongly influenced the results obtained with real-time B-mode ultrasonography with a reported sensitivity of approximately 50% in the studies performed adopting an appropriate methodology. In conclusion, noninvasive diagnostic methods are inaccurate in the diagnosis of asymptomatic deep vein thrombosis. Thus, venography remains the only accurate diagnostic method for the diagnosis of asymptomatic deep vein thrombosis.

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Section: L-fibrinogen Leg Scanningmentioning

confidence: 99%

Diagnosis of Deep Vein Thrombosis in Asymptomatic High-Risk Patients

Agnelli¹,

Radicchia²,

Nenci³

1995

Pathophysiol Haemos Thromb

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“…(6) all patients accounted for at the conclusion of the Were venograms performed in both legs? (8) Were p sibk contaminant treatments excluded?…”

Section: Evaluation Of Published Trialsmentioning

confidence: 99%

Prophylactic Agents for Venous Thrombosis in Elective Hip Surgery

Mohr

Silverstein²,

Murtaugh³

et al. 1993

Arch Intern Med

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Multiple agents or combinations are effective prophylaxis for deep venous thrombosis, but none decreases the rate to zero. There was overlap in the 95% confidence intervals for the probability of deep venous thrombosis for various agents and especially for the probabilities for proximal thrombi. Many agents have not been compared directly with each other, but low-molecular-weight heparin consistently performed well.

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“…The primary thrombus localization following hip surgery, however, is in the proximal veins, and, given the low diagnostic accuracy of leg scanning in proximal DVT, the results of these trials should be interpreted with caution [35,36].…”

Section: Orthopedic Surgerymentioning

confidence: 99%

Clinical studies with low‐molecular‐weight heparin(oid)s: An interim analysis

et al. 1988

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In this review an interim analysis was made of all clinical studies performed with low-molecular-weight heparin(oid)s (LMWH) up to January 1987. Thus far, many experimental studies on LMWH show these substances to have an increased benefit/risk ratio concerning efficacy and bleeding as compared to standard heparin. In man, this increased ratio was verified in some small open studies. However, until the present day, controversy still exists. Some of the difficulties in assessing the results of different investigations include the existence of various kinds of LMWH and the lack of a consensus as to the unitage in which they are expressed. Furthermore, no international agreement exists as to the test measuring dosage/effect and its standard. In the following review all published clinical studies were analyzed for patient groups. Important issues concerning controversy with regard to efficacy, bleeding risk, diagnosis, and testing are discussed. In general, it may be concluded that LMWH have an antithrombotic potential comparable to that of heparin, and that the benefit/risk ratio i.e., decreased bleeding potential when compared to standard heparin, as found in animal experiments, has not been clearly demonstrated in man.

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Cuff-impedance phlebography and 125I fibrinogen scanning versus roentgenographic phlebography for diagnosis of thrombophlebitis following hip surgery. A preliminary report

Cited by 61 publications

References 0 publications

Diagnosis of Deep Vein Thrombosis in Asymptomatic High-Risk Patients

Diagnosis of Deep Vein Thrombosis in Asymptomatic High-Risk Patients

Prophylactic Agents for Venous Thrombosis in Elective Hip Surgery

Clinical studies with low‐molecular‐weight heparin(oid)s: An interim analysis

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