title: Prospective comparison of the pneumatic cuff and manual compression methods in diagnosing lower extremity venous reflux.
abstract: OBJECTIVE
  To compare pneumatic cuff with manual compression in diagnosing reflux in patients with chronic venous insufficiency (CVI).
  
  
  METHODS
  Eighteen patients (Clinical Etiologic Anatomic Pathophysiologic [CEAP 2-5], median Venous Clinical Severity Score [VCSS 6.5]) were studied. The VenaPulse device (ACI Medical, San Marcos, California) was used for cuff inflation. The hemodynamic performance of the 2 methods was tested in the first 9 patients, while their diagnostic value was tested in the last 9 patients.
  
  
  RESULTS
  Both methods induced equal compression with median peak velocity of the antegrade flow (PVA) being 86 cm/s (P = .65). Coefficient of variation (CV) for PVA in the superficial veins was significantly higher with the manual method (16.8%) compared to the VenaPulse method (9.5%, P <.001), while sensitivity and specificity were 85% and 100%, and 78% (kappa .68, P <.001) and 100%, respectively.
  
  
  CONCLUSIONS
  Pneumatic cuff and manual compression were shown to be equally effective in diagnosing venous reflux. Cost-effectiveness and ease-of-use studies comparing these methods are justified.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
authors.forename: Stavros K
authors.initials: SK
authors.lastname: Kakkos
authors.forename: Judith C
authors.initials: JC
authors.lastname: Lin
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sparks
authors.forename: Melissa
authors.initials: M
authors.lastname: Telly
authors.forename: Michalene
authors.initials: M
authors.lastname: McPharlin
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Reddy
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D014111:Tourniquets; D018616:Ultrasonography, Doppler, Duplex; D014689:Venous Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology