A Diagnostic Strategy Involving a Quantitative Latex d-Dimer Assay Reliably Excludes Deep Venous Thrombosis

Abstract

A negative result on a quantitative latex d -dimer assay safely eliminates the need for further testing in patients with low or moderate pretest probability of DVT.

Using an age-dependent D-dimer cut-off value increases the number of older patients in whom deep vein thrombosis can be safely excluded

“…4 The results and inclusion and exclusion criteria have been reported previously. 4 All patients underwent a sequential diagnostic investigation, consisting of clinical probability assessment using the Wells rule 13 and a quantitative latex D-dimer test (MDA D-Dimer assay, bioMérieux, Inc.).…”

“…4 The results and inclusion and exclusion criteria have been reported previously. 4 All patients underwent a sequential diagnostic investigation, consisting of clinical probability assessment using the Wells rule 13 and a quantitative latex D-dimer test (MDA D-Dimer assay, bioMérieux, Inc.). DVT was ruled out based on: (i) a non-high clinical probability in combination with a normal D-dimer test result or (ii) a normal (repeated) CUS result in patients with a high clinical probability of DVT or an abnormal D-dimer test result -CUS was repeated in patients with normal results on CUS at presentation on days 6 to 8 and days 13-15.…”

“…The diagnosis of DVT can be safely excluded based on the combination of a low or intermediate clinical probability combined with a negative D-dimer blood test, in which case imaging studies can be avoided. [2][3][4][5] With increasing age, however, the specificity of the D-dimer test decreases, resulting in more false positive test results in older patients than in younger ones. 6,7 In clinical practice, this means that VTE can less often be excluded based on the clinical probability/D-dimer combination in older patients than in younger patients, hence older patients more often need additional testing (i.e.…”

Diagnosis of DVT

“…Table S1 lists the 21 diagnostic algorithms evaluated with this model. [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] This article focuses on the identifi cation of optimal strategies for the diagnosis of clinically suspected DVT in adults. Consecutive sections of this chapter concentrate on fi rst DVT, recurrent DVT, upper extremity DVT, and DVT during pregnancy.…”

Negative d-dimer result to exclude recurrent deep venous thrombosis: A management trial

“…Studies in patients with a suspected first episode of venous thromboembolism have shown that some of these assays have high sensitivity for acute DVT or pulmonary embolism (11). D-dimer has been used safely as an exclusion test in patients presenting with their first episode of DVT (12)(13)(14). The sensitivity of the STA-Liatest D-di (Diagnostica Stago, Asnieres-sur-Seine, France, and Parsippany, New Jersey) has been reported to be 96% to 100% in patients with suspected first-episode DVT or symptomatic pulmonary embolism (15,16).…”