Air Plethysmography for the Detection of Acute DVT: New Criteria

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Abstract
In order to determine the value of air plethysmography (APG) in the detection of acute deep vein thrombosis (DVT), the authors studied prospectively 79 consecutive patients referred for suspected acute DVT. All patients were examined with venography and APG. Venography demonstrated acute DVT in 38 patients. In 8 patients the DVT was confined to the calf and in 30 this was in the popliteal and/or more proximal veins. Venography was negative in 41 patients. An outflow fraction value with superficial occlusion of the long saphenous vein at the knee of less than 28% in combination with a venous volume of less than 50 mL identified all patients with acute proximal DVT. There was one false-positive result. However, isolated calf vein thrombi were equally distrib uted, and half of them were not detected. Air plethysmography is a reliable, inexpensive, easy to perform, and accurate nonin vasive test for the diagnosis of proximal acute DVT. It may be a useful screening test when there is a big demand for noninvasive tests, and relatively little time is available on a duplex scanner.