Upper extremity impedance plethysmography in patients with venous access devices.
Central venous access devices (VADs) are often associated with thrombotic obstruction of the axillary-subclavian venous system. To explore the accuracy of impedance plethysmography (IPG) in identifying this complication we performed IPG on 35 adult cancer patients before their VADs were placed and approximately 6 weeks later. At the time of the second IPG the patients also underwent contrast venography of the axillary-subclavian system. The venograms revealed partial venous obstruction in 12 patients (34%) and complete obstruction in two (5.7%). Although the IPG results from venographically normal and abnormal patients overlapped extensively, mean measurements of venous outflow were significantly lower in the patient population with abnormal venograms (P = 0.052 for Vo; P = 0.0036 for Vo/Vc). In our hands, therefore, upper extremity IPG cannot be used to make clinical decisions about individual patients with VADs, but it can distinguish venographically normal and abnormal populations.
Horne
M K
MK
Clinical Pathology Department, Warren G. Magnuson Clinical Center, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
Mayo
D J
DJ
Alexander
H R
HR
Steinhaus
E P
EP
Chang
R C
RC
Whitman
E
E
Gralnick
H R
HR
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001132:Arm / Q000098:blood supply*; D001367:Axillary Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D010690:Phlebography; D010992:Plethysmography, Impedance; D016037:Single-Blind Method; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013927:Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology
D000970:Antineoplastic Agents