Plethysmographic Measurement of Venous Flow Resistance and Venous Capacity in the Human Leg. Part One: Method

Rouweler, B. J. F. Klein; Brakkee, A. J. M.; Kuiper, Jacob

doi:10.1177/026835558900400405

Cited by 17 publications

(13 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the distal veins the CV varied even more ; due to the small diameters a change in diameter cannot be reliably measured. It is known that many variables can affect the venous diameter [26]. In our study the most important variable, the examination position, was standardized.…”

Section: Discussionmentioning

confidence: 99%

Venous duplex scanning of the leg: range, variability and reproducibility

et al. 1999

View full text Add to dashboard Cite

Despite the many studies on venous haemodynamics using duplex, only a few evaluated the normal values, variability and reproducibility. Therefore, the range and variability of venous diameter, compressibility, flow and reflux were measured. To obtain normal values, 42 healthy individuals (42 limbs, 714 vein segments) with no history of venous disease were scanned by duplex. To determine the reproducibility the intra-observer variability was measured in 11 healthy individuals (187 vein segments) and the inter-observer variability in 15 healthy individuals (255 vein segments) and 13 patients (169 vein segments) previously diagnosed with deep venous thrombosis. Of the 714 normal vein segments, 708 (99%) were traceable, including the crural veins. Of the traceable vein segments, 675 (95%) were compressible and in 696 (98%) flow was present. Of the 42 common femoral vein segments, in 25 (60%) the reflux duration exceeded 1.0 s, but in the other proximal vein segments the reflux duration was less than 1.0 s (95% confidence interval 3.0-10.0). With the exception of the distal long saphenous vein, in the distal vein segments the reflux duration was less than 0.5 s (95% confidence interval 3.5-8.2). The coefficient of variation of the diameter measurements ranged from 14 to 50% and that of the reflux measurements from 28 to 60%. The kappa-coefficient of the inter-observer variability in the classification of compressibility measurements in the patients was 0. 77 and that of the reflux measurements was 0.86. This study shows that almost all veins were compressible in healthy individuals, except the distal femoral veins. In healthy individuals the duration of reflux of the proximal veins was less than 1.0 s and in the distal veins it was less than 0.5 s. The inter-observer variability of the reflux and compressibility measurements in the patients was good.

show abstract

Section: Discussionmentioning

confidence: 99%

Venous duplex scanning of the leg: range, variability and reproducibility

et al. 1999

View full text Add to dashboard Cite

show abstract

“…The VOR was measured in both extremities by straingauge plethysmography as described previously [9,10]. In summary the patients were examined in supine position with pneumatic cuffs around the thighs and strain gauges around the calves.…”

Section: Methodsmentioning

confidence: 99%

Multilayer compression bandaging in the acute phase of deep-vein thrombosis has no effect on the development of the post-thrombotic syndrome

Roumen-Klappe

Heijer

Rossum

et al. 2008

J Thromb Thrombolysis

View full text Add to dashboard Cite

Objective The purpose of this randomized study was to evaluate the influence of immediate multilayer compression bandages before application of elastic stockings in the acute phase of deep-vein thrombosis (DVT) on development of the post-thrombotic syndrome (PTS). Methods Sixty-nine patients with acute symptomatic DVT were randomized to immediate bandaging (n = 34) or no bandaging (n = 35). After reduction of edema sized-to-fit elastic stockings were applied in all patients after 7-14 days. Follow-up visits and non-invasive examinations were planned after 7, 30 and 90 days and 1 year. Venous outflow resistance (VOR) was measured by strain gauge plethysmography. Thrombosis score (TS) and reflux were measured by duplex scanning. After one year patients were evaluated for clinical PTS using both the clinical scale of the CEAP classification and the Villalta score. Results Improvement of clinical symptoms and decrease of leg circumference was better on day 7 in the bandaging group, but after 1 and 3 months clinical symptoms had improved equally in both groups. In 7 patients in the no-bandaging group a bandage was applied after all because of persistent edema after 10 days. There were no differences in VOR, TS and reflux. Using the CEAP classification the incidence of PTS was 39% in patients with bandages and 42% in patients without bandages (RR 0.91,. Using the Villalta score the incidence of PTS was resp. 29 and 33% (RR 0.87, 95% CI 0.41-1.8). There was no difference in severity of PTS. Conclusion Immediate multilayer compression bandaging in the acute phase of DVT is effective in reducing edema and complaints in the first week, but has no effect on thrombus regression, valve incompetence and the development of clinical PTS after 1 year.

show abstract

“…Follow-up visits and non-invasive examinations were planned after 7, 30 and 90 days. VOR was measured in both extremities using strain-gauge plethysmography with the patient in a supine position with pneumatic cuffs around the thighs and strain gauges around the calves [9,10]. After inflation of the cuffs the venous volume increases gradually.…”

Section: Outcome Measures Of Venous Non-invasive Examinationsmentioning

confidence: 99%

Inflammation in deep vein thrombosis and the development of post-thrombotic syndrome: a prospective study

Roumen-Klappe¹,

Janssen²,

Rossum³

et al. 2009

Journal of Thrombosis and Haemostasis

128

View full text Add to dashboard Cite

To cite this article: Roumen-Klappe EM, Janssen MCH, van Rossum J, Holewijn S, van Bokhoven MMJA, Kaasjager K, Wollersheim H, den Heijer M. Inflammation in deep vein thrombosis and the development of post-thrombotic syndrome: a prospective study. J Thromb Haemost 2009; 7: 582-7.Summary. Background: The aim of this study was to investigate whether inflammatory markers (interleukin-6 [IL-6] and Creactive protein [CRP]) in the acute phase of deep vein thrombosis (DVT) are associated with elevated venous outflow resistance (VOR), thrombosis score (TS), reflux and the development of clinical post-thrombotic syndrome (PTS). Methods: In 110 patients with a first DVT, plasma concentrations of IL-6 and CRP were determined on the day of admission. VOR, TS and reflux were measured 7 days, 1 and 3 months after diagnosis. After 1 year patients were evaluated for PTS using the Clinical, Etiologic, Anatomic and Pathophysiologic (CEAP) classification and Villalta scale. Results: Median levels of IL-6 and CRP were 7 pg mL )1 and 21 mg L )1, respectively. After 3 months, VOR was elevated in 33 patients (30%), TS in 33 (30%) and reflux in 57 (52%). Incidence of PTS was 36.7% using CEAP ‡ 3 and 35.4% using Villalta-scale ‡ 5. Elevated levels of IL-6 and CRP were related to higher outcomes of VOR after 3 months [relative risks (RR) 2.4 (95% CI 1.5-3.9) and 1.4 (1.1-3.3), respectively] and for IL-6 to TS [1.5 (1.1-2.1)]. For reflux no relation was found. After 90 days, elevated outcomes of VOR, TS and reflux were related to PTS after 1 year. The association of IL-6 and CRP with PTS was weak using the CEAP classification with a RR of 1.2 (0.7-2.2) and 1.8 (0.9-3.3) and absent according to the Villalta scale 0.6 (0.2-1.4) and 1.2 (0.6-2.5), respectively. Conclusion: The results of this study suggest that inflammation might play a role in incomplete thrombus clearance, venous outflow obstruction and the development of PTS after 1 year.

show abstract

Plethysmographic Measurement of Venous Flow Resistance and Venous Capacity in the Human Leg. Part One: Method

Cited by 17 publications

References 9 publications

Venous duplex scanning of the leg: range, variability and reproducibility

Venous duplex scanning of the leg: range, variability and reproducibility

Multilayer compression bandaging in the acute phase of deep-vein thrombosis has no effect on the development of the post-thrombotic syndrome

Inflammation in deep vein thrombosis and the development of post-thrombotic syndrome: a prospective study

Contact Info

Product

Resources

About