Upper extremities deep venous thrombosis: comparison of light reflection rheography and colour duplex ultrasonography for diagnosis and follow-up.
BACKGROUND
Non-invasive diagnosis of axillary-subclavian vein thrombosis or documentation of the post-thrombotic syndrome performing methods currently in use is not definitive. The purpose of this prospective study was to compare two methods for the diagnosis and follow-up of patients with primary and secondary axillary-subclavian vein thrombosis: light reflection rheography (LLR) which is a reflection of venous pressure changes in the extremity as record from the subdermal capillary plexus, and colour duplex ultrasonography (CDUS).


METHODS
In 36 patients with primary and secondary axillary-subclavian vein thrombosis were used a 4006 GE (Milwaukee, USA) colour duplex ultrasonography and an AV-1000 Hemodynamics instrument for the light reflection rheography for diagnosis and follow-up. The LLR methodology that applied was simple, involving testing of the venous outflow in the upper extremities in response to exercise, and with normally respiratory variations of an open venous system that was also assessed by the non-invasive modalities. In the LLR application of venous congesting pressure, and measurement of the rate of venous outflow when the congesting pressure is released was also performed.


RESULTS
Both methods were able to diagnose the axillary-subclavian thrombosis in the initial acute state. There were no cases of false-positive results in either method. The CDUS presented a lower sensitivity in comparison to LLR in the follow-up period of the patients. A positive study was confirmed by phlebography in each instance.


CONCLUSIONS
The tracing obtained by LLR is easy to interpret and provides objective evidence of proximal venous occlusion. The test is easy to apply and the instrumentation is relatively inexpensive. Both LLR and CDUS, could prove to be an exciting development among non invasive diagnostic techniques for axillary-subclavian vein thrombosis, with major sensitivity of LLR in the follow-up.
Petrakis
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1st Department of General Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy. petrakis@post.com
Sciacca
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Katsamouris
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D000328:Adult; D000368:Aged; D001132:Arm / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D010992:Plethysmography, Impedance / Q000379:methods*; D012542:Scattering, Radiation; D018615:Ultrasonography, Doppler, Color; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000175:diagnosis*