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

Abstract

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% (κ .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.

Keywords

vascular lab varicose veins pneumatic compression

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