A randomized management study of impedance plethysmography vs. contrast venography in patients with a first episode of clinically suspected deep vein thrombosis

Thrombosis Research
S R KahnJ Leclerc

Abstract

In this randomized management study, we examined the safety of withholding anticoagulation on the basis of negative impedance plethysmography (IPG) compared to negative contrast venography (CV) in symptomatic patients with a first episode of clinically suspected deep vein thrombosis (DVT), and we determined the impact of the limitations of IPG or CV on their clinical utility. Patients at a university teaching hospital presenting with a first episode of clinically suspected DVT were randomized to one of two management strategies at study entry: (1) IPG: if positive, confirmatory CV was performed. If CV was positive, anticoagulants were administered, if CV was negative, anticoagulants were held. If negative, IPG was repeated serially and if it remained negative, anticoagulants were held (n = 165). (2) CV: if positive, anticoagulants were administered, if negative, anticoagulants were held (n = 159). The negative predictive value (NPV) of IPG and CV, positive predictive value (PPV) of IPG, and the failure rate of each strategy were assessed. Among IPG patients, 28 of 37 with positive IPG initially or during serial testing and evaluable CV had confirmed DVT (PPV 76%; 95% confidence interval, CI [62%, 90%]). DVT was diagnosed during...Continue Reading

References

Feb 1, 1972·Archives of Surgery·K Rabinov, S Paulin
May 27, 1995·Lancet·P S WellsP Prandoni

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Citations

Dec 14, 2005·Ultrasound Quarterly·E James Andrews, Arthur C Fleischer
Dec 17, 2003·British Journal of Haematology·David M KeelingUNKNOWN Haemostasis and Thrombosis Task Force of the British Committee for Standards in Haematology

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