Surveillance of deep vein thrombosis in asymptomatic total hip replacement patients. Impedance phlebography and fibrinogen scanning versus roentgenographic phlebography.
Nine hundred thirty-seven limbs in 537 patients over the age of 39 years who underwent total hip replacement were studied by roentgenographic phlebography, cuff-impedance phlebography, and iodine-125 fibrinogen scanning. Cuff-impedance phlebography had a sensitivity of only 12.3 percent for thigh thrombi. Fibrinogen scanning had a sensitivity of only 59.1 percent for calf thrombi and 13.7 percent for thigh thrombi. The combined use of the two methods resulted in only a 23.2 percent sensitivity for thigh thrombi and an overall sensitivity of 47.4 percent. We have concluded that in asymptomatic patients, in contrast with symptomatic patients, the combination of cuff-impedance phlebography and fibrinogen scanning is not an effective screening method.
Paiement
G
G
Department of Orthopedic Research, Massachusetts General Hospital, Boston 02114.
Wessinger
S J
SJ
Waltman
A C
AC
Harris
W H
WH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005340:Fibrinogen; D006622:Hip Prosthesis; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011183:Postoperative Complications; D011877:Radionuclide Imaging; D013924:Thrombophlebitis / Q000000981:diagnostic imaging*
D007457:Iodine Radioisotopes; D005340:Fibrinogen