Sensitivity and Specificity of Ultrasonography in the Diagnosis of Upper Extremity Deep Vein Thrombosis

Mustafa, Bisher; Rathbun, Suman; Whitsett, Thomas L.; Raskob, Gary E.

doi:10.1001/archinte.162.4.401

Cited by 109 publications

(65 citation statements)

References 21 publications

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“…Sua acurácia melhora na medida em que os examinadores se tornam mais experientes e os aparelhos evoluem com melhor imagem e mais recursos. As limitações do MD, particularmente em TVPMS, são: impossibilidade de compressão e dificuldade de visualização das veias que transitam abaixo de estruturas ósseas, ser examinador dependente e ter sensibilidade variável 20 , particularmente nos membros superiores. No entanto, o MD é o método preferível de diagnósti-co, devendo ser utilizada a flebografia nos casos de dúvida no MD 7,12,21 .…”

Section: Resultsunclassified

Trombose venosa profunda de membros superiores: estudo coorte retrospectivo de 52 casos

et al. 2005

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275 ResumoObjetivo: Rever os fatores predisponentes e a evolução em série de casos de trombose venosa profunda dos membros superiores de nossa instituição.Métodos: Cinqüenta e dois pacientes consecutivos, com trombose venosa profunda dos membros superiores (29 homens e 23 mulheres), idade média de 52,3 anos, documentados por mapeamento dúplex (71,1%), flebografia (11,1%) ou clinicamente (15,6%), foram incluídos no presente estudo.Resultados: As manifestações clínicas foram: dor no antebraço (24 casos -46,1%), dor no braço (27 casos -51,9%), edema do membro superior (45 casos -86,5%), dor à compressão do membro superior (36 casos -70,2%) e dor à movimentação do mesmo (32 casos -61,7%). Os principais fatores de risco foram: punção ou acesso venoso (20 casos -39,1%) e câncer (16 casos -32,6%). As veias envolvidas foram: umeral (n = 18), axilar (n = 27), subclávia (n = 15) e jugular (n = 11). A embolia pulmonar estava inicialmente presente em quatro casos (7,6%). O tratamento inicial foi feito com heparina não-fracionada intravenosa (64,3%), subcutânea (16,7%), ou heparina de baixo peso molecular (17,1%), seguido de varfarina. Doze pacientes morreram antes da alta, em função de causas não relacionadas à embolia pulmonar. Foram acompanhados os 40 pacientes restantes por período de 3 meses a 10 anos, sendo que dois morreram de causas não relacionadas à embolia pulmonar, um paciente desenvolveu seqüelas pós-trombóticas, como edema residual e limitações aos movimentos, e seis ficaram com discretos sintomas residuais (edema e dor).Conclusões: A trombose venosa profunda dos membros superiores foi mais freqüente em pacientes submetidos a acessos venosos e com neoplasia em atividade. Comparando com dados da literatura, a evolução dos pacientes sob tratamento exclusivo com anticoagulantes foi, no mínimo, similar a outros tratamentos propostos.Palavras-chave: trombose, trombose venosa, extremidade superior, anticoagulantes. AbstractObjective: To review the predisposing factors and the evolution of upper-extremity deep vein thrombosis in a series of cases.Methods: Fifty-two consecutive patients (29 men and 23 women, mean age of 52.3 years) with upper-extremity deep vein thrombosis documented by duplex scan (71.1%), phlebography (11.1%) or clinically (15.6%) were included in the study.Results: Clinical manifestations were: forearm pain (24 cases -46.1%), arm pain (27 cases -51.9%), upper limb edema (45 cases -86.5%), pain to arm compression (36 cases -70.2%) and to arm movement (32 cases -61.7%). Main risk factors were: vein puncture (20 cases -39.1%), and cancer (16 cases -32.6%). Deep vein thrombosis involved humeral (n = 18), axillary (n = 27), subclavian (n = 15) and jugular (n = 11) veins. Pulmonary embolism was initially present in four cases (7.6%). Initial therapy included unfractionated heparin, intravenous (64.3%), subcutaneous (16.7%) or low molecular weight heparin (17.1%) administration, followed by warfarin. Twelve patients died before discharge from the hospital, due to causes not related to pulmonary embolism. T...

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Section: Resultsunclassified

Trombose venosa profunda de membros superiores: estudo coorte retrospectivo de 52 casos

et al. 2005

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“…Kolda ani başlayan ağrı, şişlik ve renk değişikliği ile başvuran genç bir hastada aşırı--zorlayıcı efor öyküsü mutlaka sorgulanmalıdır. Aşırı --tekrarlayan efor öyküsü hastaların %75'inden fazlasında mevcuttur (26 Paget--Schroetter sendromu düşünülen hastaların görüntülemesinde ilk tercih non--invazif olması, kolay uygulanması, maliyetinin az olması, periferik derin ven trombozlarını %56--100 duyarlılık ve %94--100 özgüllük ile göstermesinden dolayı venöz doppler ultrasonografidir (29). Ultrasonografi ile tüm vakaları yakalayamamanın yanı sıra trombüse bağlı oklüzyonun derecesi ve büyüklüğünü tanımlama, kollateral dolaşımı değerlendirme ve eksternal kompresyon hakkında fazla bilgi vermesi açısından tanıda kullanılan altın standart yöntem ise kontrast venografidir (30).…”

Section: Tanıunclassified

Paget - Schroetter Syndrome in Athletes (Primary Effort Thrombosis)

et al. 2017

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“…Most patients with catheterassociated thrombosis are asymptomatic but up to one-third can have a variety of consequences that include catheter dysfunction resulting in inadequate or unsuccessful dialysis, infection, pulmonary thromboembolism, and failure of maturation of the ipsilateral arteriovenous fistula (22). Although venography is the gold standard for the diagnosis of upper extremity deep venous thrombosis, duplex ultrasonography is the method of choice (24). When combined with Doppler, duplex ultrasonography has 100% sensitivity and 93% specificity for the diagnosis of upper extremity deep venous thrombosis and catheter-associated thrombosis (24).…”

Section: Question 2bmentioning

confidence: 99%

“…Although venography is the gold standard for the diagnosis of upper extremity deep venous thrombosis, duplex ultrasonography is the method of choice (24). When combined with Doppler, duplex ultrasonography has 100% sensitivity and 93% specificity for the diagnosis of upper extremity deep venous thrombosis and catheter-associated thrombosis (24).…”

Section: Question 2bmentioning

confidence: 99%

American Society of Nephrology Quiz and Questionnaire 2013

Mehrotra

Perazella

Choi

2014

Clinical Journal of the American Society of Nephrology

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The Nephrology Quiz and Questionnaire (NQ&Q) remains an extremely popular session for attendees of the Annual Meeting of the American Society of Nephrology. As in past years, the conference hall of the 2013 meeting was overflowing with interested audience members. Topics covered by expert discussants included electrolyte and acid-base disorders, glomerular disease, ESRD/dialysis, and transplantation. Complex cases representing each of these categories, along with single best answer questions, were prepared by a panel of experts. Before the meeting, program directors of United States nephrology training programs answered questions through an Internet-based questionnaire. A new addition to the NQ&Q was participation in the questionnaire by nephrology fellows. To review the process, members of the audience test their knowledge and judgment on a series of caseoriented questions prepared and discussed by experts. Their answers are compared in real time using audience response devices with the answers of nephrology fellows and training program directors. The correct and incorrect answers are then briefly discussed after the audience responses and the results of the questionnaire are displayed. This article recapitulates the session and reproduces its educational value for CJASN readers. Enjoy the clinical cases and expert discussions.

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Sensitivity and Specificity of Ultrasonography in the Diagnosis of Upper Extremity Deep Vein Thrombosis

Abstract: The safety of withholding anticoagulant treatment in a patient with suspected upper extremity deep vein thrombosis and negative ultrasonographic results is uncertain.

Cited by 109 publications

References 21 publications

Trombose venosa profunda de membros superiores: estudo coorte retrospectivo de 52 casos

Trombose venosa profunda de membros superiores: estudo coorte retrospectivo de 52 casos

Paget - Schroetter Syndrome in Athletes (Primary Effort Thrombosis)

American Society of Nephrology Quiz and Questionnaire 2013

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