Diagnosis of Recurrent Deep Vein Thrombosis

Abstract

Long-term follow-up studies demonstrated that venous thromboembolism is a chronic disease, as the rate of recurrent deep vein thrombosis (DVT) continuously increases after the primitive thrombotic episode. Objective testing is mandatory to confirm or refute the presence of recurrent DVT, as only 30% of patients with suspected recurrence have a new documented thrombotic episode. There is no consensus on the preferred diagnostic procedure; furthermore, both invasive and noninvasive methods are limited in this context. Venography, the established gold standard, is invasive, costly, inconvenient and requires high technical skills. Among noninvasive techniques, serial impedance plethysmography, alone or in combination with leg scanning and venography, and serial compression ultrasound (CUS), were adequately investigated. At present, the recommended approach is represented by a quantitative CUS method that possesses an excellent reproducibility and accuracy. The safety of withholding anticoagulants from patients with a normal quantitative CUS work-up has been recently demonstrated in a prospective management study.

Recurrent Deep Vein Thrombosis

“…Modalities for diagnosing recurrence vary with some methods being available in academic settings only. Ultrasound is been the most common method for detecting recurrent DVT 6 and was chosen for our study. We examined the long-term incidence, risk factors, and associated morbidity and mortality of recurrent DVT.…”

A Patient with Deep Vein Thrombosis Presenting to a Chiropractic Clinic: A Case Report

“…28 Venography is the most sensitive and accurate test for DVT diagnosis and is regarded as the gold standard, 2 yet it is invasive, costly, inconvenient, and requires high technical skill from the operator. 4,29 Venography should be reserved for those patients with negative noninvasive tests and high clinical probability or for those whom noninvasive tests are ambiguous or nonfeasible. 2 d-Dimer or ultrasound tests along with the prediction rule can reduce the need for contrast venography as well as the likelihood of false-positive or false-negative test results.…”

Providing accurate information to patients who develop deep vein thrombosis

“…2 Another study that looked at 1-year follow-up scans in patients with deep vein thrombosis (DVT) showed that residual thrombus is present in about 50% of cases. 3 This fact may complicate the management of patients who develop symptoms on discontinuing anticoagulation after the planned period of 3-6 months. After a first episode of DVT, about half of patients will develop complaints suggestive of recurrent DVT.…”