Is bilateral ultrasound scanning of the legs necessary for patients with unilateral symptoms of deep vein thrombosis?

Garcia, Nicholas D.; Morasch, Mark D.; Ebaugh, James L.; Shah, S.S.; Blackburn, Donna; Astleford, Patricia; Matsumura, Jon S.; Yao, James S.T.; Pearce, William H.

doi:10.1067/mva.2001.118805

Cited by 17 publications

(18 citation statements)

References 15 publications

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“…Outpatients generally are healthier and are less likely to have other comorbidities that may increase the risk of thrombosis in the asymptomatic limb. Garcia et al 9 reported that 5% of their 250 inpatients in their study had DVT in only the asymptomatic leg. None of their 276 outpatients had thrombus confined to the asymptomatic leg.…”

Section: Discussionmentioning

confidence: 97%

Duplex scan for deep vein thrombosis—defining who needs an examination of the contralateral asymptomatic leg

Pennell

Mantese

Westfall

2008

Journal of Vascular Surgery

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Inpatients have a very high incidence of clinically silent contralateral thrombosis (34%) and should usually undergo bilateral examinations. Patients with active malignancy have a 38% incidence of asymptomatic contralateral clot and should always have a bilateral study. Outpatients with unilateral symptoms and no associated risk factors for thrombosis can safely undergo unilateral examinations and should be adequately treated according to the unilateral findings. Algorithms to select patients for limited studies should include screening data for active malignancy, recent trauma or surgery, pregnancy, hormone therapy, or history of thrombophilia.

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Section: Discussionmentioning

confidence: 97%

Duplex scan for deep vein thrombosis—defining who needs an examination of the contralateral asymptomatic leg

Pennell

Mantese

Westfall

2008

Journal of Vascular Surgery

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“…21,22 According to various authors, the percentage of detected distal DVT ranges from 5 to 76.5%. 23,24 DVT pharmacological prophylaxis with LMWH decreases its rate of what has been reported through multiple studies. 5,14,25,26 Most of the authors recommend the aforementioned level of prophylaxis until the end of the 2nd 1,25 or 3rd month post-injury.…”

Section: 3710mentioning

confidence: 99%

Deep venous thrombosis in patients with chronic spinal cord injury

Mackiewicz−Milewska

Jung

Kroszczyński³

et al. 2015

The Journal of Spinal Cord Medicine

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Context/Objective: Deep venous thrombosis (DVT) is a well-known complication of an acute spinal cord injury (SCI). However, the prevalence of DVT in patients with chronic SCI has only been reported in a limited number of studies. The aim of our study was to examine the prevalence of DVT in patients with SCI beyond three months after injury. Design: Cross-sectional study. Setting: Rehabilitation Department at the Bydgoszcz University Hospital in Poland. Participants: Sixty-three patients with SCI that were more than 3 months post injury. The patients, ranging in age from 13 to 65 years, consisted of 15 women and 48 men; the mean age of the patients was 32.1 years. The time from injury varied from 4 to 124 months. Outcome measures: Clinical assessment, D-dimer and venous duplex scan. Results: The venous duplex scan revealed DVT in 5 of the 63 patients. The post-injury time in four of the patients varied between 4 and 5 months; one patient was 42 months post-injury. Conclusion: DVT occurred in patients with chronic SCI, mainly by the 6th post injury month.

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“…Likewise, although contrast venography is considered the criterion standard for DVT, VDUS has become the ''standard of care.'' [4][5][6]13,14 Second, a study of consecutive patients would have eliminated possible selection bias, although the two previous prospective studies were also limited by convenience samples. It may be that those patients whom an EP-sonographer feels comfortable examining with US can be adequately assessed.…”

Section: Limitationsmentioning

confidence: 99%

“…Contrast venography is the criterion standard for diagnosing DVT, but it is invasive and has been replaced by venous duplex ultrasonography (VDUS) as the initial diagnostic test. [4][5][6] Recently, some centers have begun using computed tomography (CT) venography, with comparable results. [7][8][9] Although most emergency departments (EDs) are able to obtain VDUS during business hours, this often requires patients' being gone from the ED for several hours.…”

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confidence: 99%

Resident-performed Compression Ultrasonography for the Detection of Proximal Deep Vein Thrombosis: Fast and Accurate

et al. 2004

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Objectives: To assess whether emergency medicine residents (EMRs) could quickly perform accurate compression ultrasonography (CUS) for the detection of proximal lower extremity deep vein thromboses (PLEDVTs) with minimal training. Methods: A prospective, observational study using a convenience sample of patients presenting with signs and/or symptoms for PLEDVT. Vascular laboratory and department of radiology studies were considered the criterion standard. CUS of the femoral vessels was performed. Incompressibility or visualized thrombus was considered ''positive.'' Results: Eight residents with limited ultrasound (US) experience and no prior experience with deep vein thrombosis (DVT) US volunteered to participate in this study, enrolling 72 patients. Their average scan time was 11.7 minutes (95% CI ¼ 9.4 to 14). There were 23 true positives, 4 false positives, 45 true negatives, and 0 false negatives. The test characteristics for PLEDVT gave a sensitivity of 100% (95% CI ¼ 82.2 to 100) and a specificity of 91.8% (95% CI ¼ 79.5 to 97.4). Conclusion: Emergency medicine residents with limited US experience were able to quickly perform CUS after minimal training for the detection of PLEDVT in a select group of patients.

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Is bilateral ultrasound scanning of the legs necessary for patients with unilateral symptoms of deep vein thrombosis?

Cited by 17 publications

References 15 publications

Duplex scan for deep vein thrombosis—defining who needs an examination of the contralateral asymptomatic leg

Duplex scan for deep vein thrombosis—defining who needs an examination of the contralateral asymptomatic leg

Deep venous thrombosis in patients with chronic spinal cord injury

Resident-performed Compression Ultrasonography for the Detection of Proximal Deep Vein Thrombosis: Fast and Accurate

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