Upper extremities deep venous thrombosis: comparison of light reflection rheography and colour duplex ultrasonography for diagnosis and follow-up

Background. Non-invasive diagnosis of axillary-subclavian vein thrombosis o r documentation of the post-thrombotic syndrome performing methods currentl y in use is not definitive. The purpose of this prospective study was to co mpare two methods for the diagnosis and follow-up of patients with primary and secondary axillary-subclavian vein thrombosis: light reflection rheogra phy (LLR) which is a reflection of venous pressure changes in the extremity as record from the subdermal capillary plexus, and colour duplex ultrasono graphy (CDUS). Methods. In 36 patients with primary and secondary axillary-subclavian vein thrombosis were used a 4006 GE (Milwaukee, USA) colour duplex ultrasonogra phy and an AV-1000 Hemodynamics instrument for the light reflection rheogra phy for diagnosis and follow-up. The LLR methodology that applied was simpl e, involving testing of the venous outflow in the upper extremities in resp onse to exercise, and with normally respiratory variations of an open venou s system that was also assessed by the noninvasive modalities. In the LLR a pplication of venous congesting pressure, and measurement of the rate of ve nous outflow when the congesting pressure is released was also performed. Results. Both methods were able to diagnose the axillary-subclavian thrombo sis in the initial acute state. There were no cases of false-positive resul ts in either method. The CDUS presented a lower sensitivity in comparison t o LLR in the followup period of the patients. A positive study was confirme d by phlebography in each instance. Conclusions. The tracing obtained by LLR is easy to interpret and provides objective evidence of proximal venous occlusion. The test is easy to apply and the instrumentation is relatively inexpensive. Both LLR and CDUS, could prove to be an exciting development among non invasive diagnostic techniqu es for axillary-subclavian vein thrombosis, with major sensitivity of LLR i n the follow-up.