The role of air plethysmography in the diagnosis of chronic venous insufficiency Enrique Criado, MD, Mark A. Farber, MD, William A. Marston, MD, Patty.

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Presentation transcript:

The role of air plethysmography in the diagnosis of chronic venous insufficiency Enrique Criado, MD, Mark A. Farber, MD, William A. Marston, MD, Patty F. Daniel, RN, RVT, Cynthia B. Burnham, RN, RVT, Blair A. Keagy, MD Journal of Vascular Surgery Volume 27, Issue 4, Pages 660-670 (April 1998) DOI: 10.1016/S0741-5214(98)70231-9 Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 1 Comparison of venous filling index (VFI) values by severity of disease for 186 limbs studied with air plethysmography. The table depicts mean differences and p values for group comparisons. Statistical significance among all three groups exists. Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 2 Comparison of the ejection fraction (EF) by severity of disease for 186 limbs studied with air plethysmography. The table depicts mean differences and p values for group comparisons. A statistically significant difference existed between normal limbs and those with severe disease, although not for other group comparisons. Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 3 Comparison of residual volume fraction (RVF) by severity of disease for 186 limbs studied with air plethysmography. The table depicts mean differences and p values for group comparisons. Statistical significance was demonstrated for comparison of the normal and severe disease groups and for the mild and severe disease groups. No difference was found between normal and mild disease groups. Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 4 Severity of disease is stratified by the venous filling index (VFI) for 186 limbs studied with air plethysmography. Numbers above the columns give the percentages of limbs for each group of severity according to the SVS/ISCVS classification of clinical severity of venous disease. Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 5 Combined effect of venous filling index (VFI) and ejection fraction (EF) on the clinical severity of disease. Although the incidence of severe disease was significantly higher (p < 0.05) in limbs with VFI values of more than 5 ml/sec, an abnormal EF value did not produce a significant difference in the incidence of severe venous disease (classes 4, 5, and 6), regardless of whether the VFI was above (p > 0.90) or below 5 ml/sec (p > 0.9). The percentages represent the limbs with severe venous disease (classes 4, 5, and 6) among limbs falling in that section of the scattergram. Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 6 Influence of the residual volume fraction (RVF) on the severity of disease in relation to the venous filling index (VFI). An abnormal RVF (>35%) did not produce a significant increase in the incidence of severe venous disease (class 4, 5, and 6) in combination with high (>5 ml/sec) or low VFI values (>2 and <5 ml/sec; p = 0.3 and p = 0.67, respectively). The percentages represent the limbs with severe venous disease (classes 4, 5, and 6) among limbs falling in that section of the scattergram. Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 7 Comparison of the venous filling index (VFI) by type of reflux for 186 limbs studied with air plethysmography. The table depicts mean differences and p values for group comparisons. Statistical significance demonstrated between all types of reflux. N, Normal limbs; S, superficial reflux; P, perforator reflux, with or without superficial; D, deep reflux, with or without superficial or perforator reflux. Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 8 Comparison of ejection fraction (EF) by type of reflux for 186 limbs studied with air plethysmography. The table depicts mean differences and p values for group comparisons. Statistical significance was demonstrated for the comparison of normal and perforator reflux and for normal and deep reflux. All other comparisons were not significant. N, Normal limbs; S, superficial reflux; P, perforator reflux, with or without superficial; D, deep reflux, with or without superficial or perforator reflux. Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 9 Comparison of residual volume fraction (RVF) by type of reflux for 186 limbs studied with air plethysmography. The table depicts mean differences and p values for group comparisons. Statistical significance was demonstrated for all types, except perforator reflux and deep reflux. N, Normal limbs; S, superficial reflux; P, perforator reflux, with or without superficial; D, deep reflux, with or without superficial or perforator reflux. Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 10 Type of reflux stratified by level of venous filling index (VFI) for 186 limbs studied with air plethysmography. The numbers above the columns indicate the percentage of limbs for each type of reflux Journal of Vascular Surgery 1998 27, 660-670DOI: (10.1016/S0741-5214(98)70231-9) Copyright © 1998 Mosby, Inc. Terms and Conditions