Doppler and photoplethysmography studies were compared with invasive venous pressure measurements in ten healthy volunteers and 20 patients with a postthrombotic syndrome to assess the accuracy of noninvasive studies in detecting venous valve incompetence in the lower extremity. Using a refilling time of 20 seconds or less for valve incompetence, photoplethysmography was as accurate as invasive pressure measurements. In the Doppler studies there were two false-positive and three false-negative studies as compared with the invasive method. Photoplethysmography is an accurate and simple method for detecting valve incompetence. The method should be used in patients with suspected chronic venous disease, in evaluation of thrombolytic agents used for acute venous thrombosis, and in evaluation of the results of venous valve reconstruction.
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