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Prospective Comparison of the Pneumatic Cuff and Manual Compression Methods in Diagnosing Lower Extremity Venous Reflux

Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Michigan

Judith C. Lin, MD, FACS

Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Michigan, jlin1{at}hfhs.org

Jennifer Sparks, RVT

Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Michigan

Melissa Telly, RVT

Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Michigan

Michalene McPharlin, RN, RVT

Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Michigan

Daniel J. Reddy, MD, FACS

Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Michigan

Aim: To compare pneumatic cuff with manual compression in diagnosing reflux in patients with chronic venous insufficiency (CVI).

Patients and 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% ( .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.

Key Words: vascular lab • varicose veins • pneumatic compression

This version was published on October 1, 2009

Vascular and Endovascular Surgery, Vol. 43, No. 5, 480-484 (2009)
DOI: 10.1177/1538574409344438


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