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Arterial Digital Pulse Photoplethysmography in Patients with Suspected Thoracic Outlet Syndrome: A Study of the “Ca+Pra” Maneuver
The level of pulse amplitude (PA) change in arterial digital pulse plethysmography (A-PPG) that should be used to diagnose thoracic outlet syndrome (TOS) is debated. We hypothesized that a modification of the Roos test (by moving the arms forward, mimicking a prayer position (“Pra”)) releasing an ev...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234081/ https://www.ncbi.nlm.nih.gov/pubmed/34205560 http://dx.doi.org/10.3390/diagnostics11061128 |
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author | Hersant, Jeanne Ramondou, Pierre Thouveny, Francine Daligault, Mickael Feuilloy, Mathieu Saulnier, Patrick Abraham, Pierre Henni, Samir |
author_facet | Hersant, Jeanne Ramondou, Pierre Thouveny, Francine Daligault, Mickael Feuilloy, Mathieu Saulnier, Patrick Abraham, Pierre Henni, Samir |
author_sort | Hersant, Jeanne |
collection | PubMed |
description | The level of pulse amplitude (PA) change in arterial digital pulse plethysmography (A-PPG) that should be used to diagnose thoracic outlet syndrome (TOS) is debated. We hypothesized that a modification of the Roos test (by moving the arms forward, mimicking a prayer position (“Pra”)) releasing an eventual compression that occurs in the surrender/candlestick position (“Ca”) would facilitate interpretation of A-PPG results. In 52 subjects, we determined the optimal PA change from rest to predict compression at imaging (ultrasonography +/− angiography) with receiver operating characteristics (ROC). “Pra”-PA was set as 100%, and PA was expressed in normalized amplitude (NA) units. Imaging found arterial compression in 23 upper limbs. The area under ROC was 0.765 ± 0.065 (p < 0.0001), resulting in a 91.4% sensitivity and a 60.9% specificity for an increase of fewer than 3 NA from rest during “Ca”, while results were 17.4% and 98.8%, respectively, for the 75% PA decrease previously proposed in the literature. A-PPG during a “Ca+Pra” test provides demonstrable proof of inflow impairment and increases the sensitivity of A-PPG for the detection of arterial compression as determined by imaging. The absence of an increase in PA during the “Ca” phase of the “Ca+Pra” maneuver should be considered indicative of arterial inflow impairment. |
format | Online Article Text |
id | pubmed-8234081 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-82340812021-06-27 Arterial Digital Pulse Photoplethysmography in Patients with Suspected Thoracic Outlet Syndrome: A Study of the “Ca+Pra” Maneuver Hersant, Jeanne Ramondou, Pierre Thouveny, Francine Daligault, Mickael Feuilloy, Mathieu Saulnier, Patrick Abraham, Pierre Henni, Samir Diagnostics (Basel) Article The level of pulse amplitude (PA) change in arterial digital pulse plethysmography (A-PPG) that should be used to diagnose thoracic outlet syndrome (TOS) is debated. We hypothesized that a modification of the Roos test (by moving the arms forward, mimicking a prayer position (“Pra”)) releasing an eventual compression that occurs in the surrender/candlestick position (“Ca”) would facilitate interpretation of A-PPG results. In 52 subjects, we determined the optimal PA change from rest to predict compression at imaging (ultrasonography +/− angiography) with receiver operating characteristics (ROC). “Pra”-PA was set as 100%, and PA was expressed in normalized amplitude (NA) units. Imaging found arterial compression in 23 upper limbs. The area under ROC was 0.765 ± 0.065 (p < 0.0001), resulting in a 91.4% sensitivity and a 60.9% specificity for an increase of fewer than 3 NA from rest during “Ca”, while results were 17.4% and 98.8%, respectively, for the 75% PA decrease previously proposed in the literature. A-PPG during a “Ca+Pra” test provides demonstrable proof of inflow impairment and increases the sensitivity of A-PPG for the detection of arterial compression as determined by imaging. The absence of an increase in PA during the “Ca” phase of the “Ca+Pra” maneuver should be considered indicative of arterial inflow impairment. MDPI 2021-06-21 /pmc/articles/PMC8234081/ /pubmed/34205560 http://dx.doi.org/10.3390/diagnostics11061128 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Hersant, Jeanne Ramondou, Pierre Thouveny, Francine Daligault, Mickael Feuilloy, Mathieu Saulnier, Patrick Abraham, Pierre Henni, Samir Arterial Digital Pulse Photoplethysmography in Patients with Suspected Thoracic Outlet Syndrome: A Study of the “Ca+Pra” Maneuver |
title | Arterial Digital Pulse Photoplethysmography in Patients with Suspected Thoracic Outlet Syndrome: A Study of the “Ca+Pra” Maneuver |
title_full | Arterial Digital Pulse Photoplethysmography in Patients with Suspected Thoracic Outlet Syndrome: A Study of the “Ca+Pra” Maneuver |
title_fullStr | Arterial Digital Pulse Photoplethysmography in Patients with Suspected Thoracic Outlet Syndrome: A Study of the “Ca+Pra” Maneuver |
title_full_unstemmed | Arterial Digital Pulse Photoplethysmography in Patients with Suspected Thoracic Outlet Syndrome: A Study of the “Ca+Pra” Maneuver |
title_short | Arterial Digital Pulse Photoplethysmography in Patients with Suspected Thoracic Outlet Syndrome: A Study of the “Ca+Pra” Maneuver |
title_sort | arterial digital pulse photoplethysmography in patients with suspected thoracic outlet syndrome: a study of the “ca+pra” maneuver |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234081/ https://www.ncbi.nlm.nih.gov/pubmed/34205560 http://dx.doi.org/10.3390/diagnostics11061128 |
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