Prospective comparison of the pneumatic cuff and manual compression methods in diagnosing lower extremity venous reflux.
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.
Kakkos
Stavros K
SK
Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
Lin
Judith C
JC
Sparks
Jennifer
J
Telly
Melissa
M
McPharlin
Michalene
M
Reddy
Daniel J
DJ
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