The inability of venous occlusion air plethysmography to identify patients who will benefit from stenting of deep venous obstruction

Background The aim of this study was to assess whether venous occlusion plethysmography can be used to identify venous obstruction and predict clinical success of stenting. Method Receiver operated characteristic curves were used to determine the ability of venous occlusion plethysmography to discriminate between the presence and absence of obstruction, measured by duplex ultrasound and magnetic resonance venography, and to discriminate between successful and non-successful stenting, measured by VEINES-QOL/Sym. Result Two hundred thirty-seven limbs in 196 patients were included. Areas under the curve for post-thrombotic obstruction were one-second outflow volume 0.71, total venous volume 0.69 and outflow fraction 0.59. Stenting was performed in 45 limbs of 39 patients. Areas under the curve for identifying patients with successful treatment at one year after stenting were 0.57, 0.54 and 0.63, respectively. Conclusion Venous occlusion plethysmography cannot be used to identify venous obstruction proximal to the femoral confluence or to distinguish which patients will benefit from treatment.