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Brachial venous pressure measurement for diagnosis of pulmonary embolism.
MedLine Citation:
PMID:  23099975     Owner:  NLM     Status:  In-Data-Review    
Background. Imaging methods for diagnosis of pulmonary embolism (PE) are not available at small medical or rural centres as well as during night time. Herein, we evaluated the diagnostic value of brachial venous pressure measurement in the diagnosis of PE in patients with deep vein thrombosis. Materials and Methods. One-hundred and fifty consecutive patients with deep vein thrombosis and suspected PE were prospectively evaluated by measuring brachial vein pressure by CW Doppler. Diagnosis of PE was made by computed tomography angiography and pulmonary angiography. Results. Seventy-one patients (47.3%) had PE. A significant correlation was observed between brachial venous pressure and systolic pulmonary artery pressure (sPAP) estimated at echocardiography (rho 0.922, p<0.0001) as well as with invasively measured sPAP (rho 0.965, p<0.0001). Brachial venous pressure was significantly higher in the PE group (38.5 vs. 13.9 mmHg, p<0.0001) and was associated with increased extent of PE (p<0.0001). A cut-off of brachial venous pressure >15 mmHg had a sensitivity of 100%, a specificity of 77% and a negative likelihood ratio of 0.0%. A cut-off of brachial venous pressure > 19 mmHg had a sensitivity of 100% and specificity of 100% as no patient with PE had a brachial venous pressure below 20 mmHg, and no patients without PE had a venous pressure above this value. Conclusions. Brachial venous pressure may assist in the diagnosis of PE at bed-side in patients with deep vein thrombosis. Further studies are needed to confirm the validity and reliability of this method. Clin Ter 2012; 163(5):e287-291.
A R Todini; D Pergolini; M Morucci; V D'Andrea; M L Paiella; V Cantisani; F Biancari
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  La Clinica terapeutica     Volume:  163     ISSN:  1972-6007     ISO Abbreviation:  Clin Ter     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-10-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372604     Medline TA:  Clin Ter     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  e287-97     Citation Subset:  IM    
Departments of Angiology and Radiology, San Camillo-Forlanini Hospital, Rome, Italy; Departments of Surgical Sciences, and Radiology, University of Rome "La Sapienza", Rome, Italy; Department of Surgery, Oulu University Hospital, Oulu, Finland.
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