Nonfilling of Contrast in Deep Leg Vein Isolated Nonfilling of Contrast in Deep Leg Vein Segments Seen on Phlebography, and a Comparison with Color Doppler Ultrasound, to Assess the Incidence of Deep Leg Vein Thrombosis

Björgell, Ola; Nilsson, Patric; Jarenros, H.

doi:10.1177/000331970005100602

Cited by 15 publications

(12 citation statements)

References 30 publications

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“…This is because nonfilling of contrast in deep veins on phlebography is claimed to be an indirect sign of DVT by some authors but rejected by others. Bjorgell et al 15 showed that isolated nonfilling of the posterior tibial and/or deep muscle veins of the calf found by phlebography may be an indirect sign of DVT but is equally commonly caused by other pathological conditions like edema, bleedings, ligament and muscle ruptures, Baker cysts, and superficial thrombophlebitis or arises without any detectable explanation.…”

Section: Discussionmentioning

confidence: 99%

Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?

2007

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Background:Venous thromboembolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is a potentially fatal disease. According to the Western literature, DVT of lower limb veins is one of the most common complications following total hip and knee arthroplasty and surgeries for lower limb fractures. Very few studies have been published from India on the subject and very little is known about the true incidence of the condition. The issue has acquired greater significance in Indian subjects in recent times as there is a manifold increase in the number of joint replacement surgeries and surgeries for lower limb fractures. There are no clear guidelines regarding the prophylaxis for VTE for Indian patients.Materials and Methods:We carried out a prospective study to determine the incidence of DVT. Present study included 125 patients undergoing total knee and hip joint arthroplasty and surgeries for fractures of the lower limb over a three-year period. All the patients underwent duplex ultrasonography between the seventh and 14th postoperative day. No mechanical or chemical form of DVT prophylaxis was used.Results:Only nine patients (7.2%) showed sonographic evidence of DVT and the majority of them resolved without treatment. There was no case of pulmonary embolism.Conclusion:DVT following total joint arthroplasty and surgery for lower limb fractures in Indian patients is not as common as reported in the Western literature. A high level of suspicion and close clinical monitoring is mandatory, routine chemoprophylaxis is perhaps not justified in every patient undergoing lower limb surgery in our opinion. More trials involving a larger number of patients and at multi centers, in future, would be required to confirm the findings of our study.

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Section: Discussionmentioning

confidence: 99%

Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?

2007

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“…Though nonfilling of contrast in deep veins on venography has been accepted as an indirect sign of DVT, Björgell et al . (2000) showed that isolated nonfilling of posterior tibial and deep muscle veins of the calf seen on venography can equally be caused by other pathological conditions like edema, bleeding, ligaments and muscle rupture, Baker's cyst, and superficial thrombophlebitis, or arises without any detectable explanation, thereby leading to an exaggerated number of patients with thrombosis in these studies 15. Nowadays, duplex ultrasonography has become the diagnostic standard in most of the hospitals in the United States, making it more representative of real-time medical management 16.…”

Section: Discussionmentioning

confidence: 95%

Role of calf muscle stimulation in the prevention of DVT in Indian patients undergoing surgeries for fractures around the hip

Goyal

Arora

Batra

et al. 2012

IJOO

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Background:The venous stasis of soleal vein during surgery may be an important factor in the development of deep vein thrombosis (DVT). The stimulation of calf muscle during surgery may help in preventing DVT. The present study is conducted to evaluate the role of peroperative calf muscle electrostimulation in prevention of DVT in patients undergoing surgeries around the hip joint.Materials and Methods:The study comprised 200 patients undergoing surgeries around the hip joint. The patients having risk factors (such as previous myocardial infarction, malignancies, paraplegia or lower limb monoplegia, previous history of DVT or varicose veins, etc.) for the development of DVT were excluded. They were randomized into two groups: 100 cases were given peroperative calf muscle electrostimulation for DVT prophylaxis (Group A) and the remaining 100 patients were taken as controls without any prophylaxis (Group B). The color Doppler ultrasound was performed to exclude pre-existing DVT and on 7th day postoperative to find out the incidence of DVT in both the groups.Results:Two patients among Group A and six patients among Group B demonstrated DVT on ultrasonography, but the difference was not found to be statistically significant (P=0.279). None of the patients had any clinical evidence of DVT.Conclusion:The role of peroperative calf muscle electrostimulation for DVT prophylaxis remains controversial. The risk of developing DVT in patients undergoing surgeries around the hip joint is very less in patients analysed in our series.

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“…However, isolated nonfilling of deep veins below the knee on phlebography was, in a recent study, successfully evaluated by subsequent color duplex sonography in 100 of 102 consecutive patients. 25 In conclusion, among patients with clinically suspected DVT and inconclusive duplex results, the number of indeterminate phlebographic findings is high, which reduces the utility of phlebography in this category of patients. Even if duplex examination findings are equivocal, it is still possible to extract clinically useful information by categorizing the duplex results into subgroups with low, intermediate, and high probability of DVT.…”

Section: Discussionmentioning

confidence: 97%

A Detailed Analysis of Equivocal Duplex Findings in Patients With Suspected Deep Venous Thrombosis

Norén

Ottosson

Sjunnesson

et al. 2002

Journal of Ultrasound in Medicine

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Even if a duplex examination is equivocal, it is still possible to extract clinically useful information by categorizing the duplex results into subgroups with low, intermediate, and high probability of deep venous thrombosis. This can have implications for the diagnostic or therapeutic handling of these patients and thus can increase the utility of sonography in patients with inconclusive duplex findings.

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Nonfilling of Contrast in Deep Leg Vein Isolated Nonfilling of Contrast in Deep Leg Vein Segments Seen on Phlebography, and a Comparison with Color Doppler Ultrasound, to Assess the Incidence of Deep Leg Vein Thrombosis

Cited by 15 publications

References 30 publications

Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?

Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?

Role of calf muscle stimulation in the prevention of DVT in Indian patients undergoing surgeries for fractures around the hip

A Detailed Analysis of Equivocal Duplex Findings in Patients With Suspected Deep Venous Thrombosis

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