Venous Duplex Imaging for the Diagnosis of Acute Deep Venous Thrombosis

Comerota, Anthony J.; Katz, Mira L.; Hashemi, Homayoun A.

doi:10.1159/000216911

Cited by 33 publications

(30 citation statements)

References 14 publications

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“…[23][24][25][26][27][28][29] When duplex scanning was used to document recurrent thrombosis in patients receiving heparin therapy for acute DVT, Krupski et al found a 38% recurrence rate within the acute period 30 -a figure that is more in accord with the cumulative incidence of recurrence observed in this study.…”

Section: Discussionsupporting

confidence: 64%

Venous thrombus stability during acute phase of therapy

et al. 1999

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Abstract:The purpose of this study was to use serial venous duplex scans to document the status of deep venous thrombi during the early phase of therapy for acute, deep-vein thrombosis (DVT). A total of 71 consecutive participants treated for a first episode of acute DVT were monitored for new venous thrombosis using serial venous duplex scans. An average of 4.6 duplex scans were performed per patient (range, three to seven) during the 3-week study period. The cumulative incidence of contiguous/non-contiguous extension of the DVT at 3 weeks was 26% (95% CI = 14% to 38%). Nine of the 15 (60%) occurrences were asymptomatic. None of the classical risk factors for DVT was significantly associated with the development of new thrombi. The fraction of time during which the level of anticoagulation was considered 'adequate' (international normalized ratio у2.0 and/or heparin concentration у0.2 IU/ml) was inversely associated with the risk of extension/new thrombi (p = 0.01, Cox proportional hazards analysis).It was concluded that: (1) the frequency of contiguous/non-contiguous extension of venous thrombosis detectable during the first 3 weeks of therapy was higher than previously reported; (2) the majority of the occurrences were asymptomatic; and (3) the risk of developing this complication was inversely associated with the level of anticoagulation achieved.

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Section: Discussionsupporting

confidence: 64%

Venous thrombus stability during acute phase of therapy

et al. 1999

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“…However, all femoral veins displayed phasicity of Doppler-signal flow and lumen diameter changes during respiration, both of which indicated patency without significant obstruction in the more proximal portion in all study veins. 18,21,24,25) Conclusion: Short-term multiple venous sheath (up to 3 sheaths) placement in a single femoral vein is acceptably safe in patients who have undergone EPS and RF ablation, even though nonocclusive DVT may develop in some patients. Although the venous outcome appears to be benign, close follow-up after an electrophysiological procedure in order to avoid potential vascular complications is still necessary.…”

Section: Discussionmentioning

confidence: 97%

“…16) Duplex ultrasonography is also becoming an important noninvasive diagnostic test with high diagnostic sensitivity and specificity for acute DVT. [17][18][19][20][21] Therefore, we utilized this technique to evaluate and monitor venous changes in the femoral veins we studied for this report.…”

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confidence: 99%

Safety and Outcomes of Short-Term Multiple Femoral Venous Sheath Placement in Cardiac Electrophysiological Study and Radiofrequency Catheter Ablation

et al. 2004

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SUMMARYMultiple intracardiac catheters are often necessary for electrophysiological study (EPS) and radiofrequency (RF) ablation therapy. Therefore, multiple venous sheath placement in one femoral vein is always required for multiple intracardiac catheter insertion. The vascular complications incurred by placement of multiple sheaths have not been fully studied. We utilized duplex ultrasonography to assess the femoral veins before and after the procedure. This study consisted of 52 patients (68 femoral veins) who underwent EPS and RF ablation therapy. Up to three sheaths were inserted into a single femoral vein. Nonocclusive deep vein thrombosis (DVT) occurred in 12/68 veins (17.6%) of 11 patients on the day following the procedure. Thrombosis regressed spontaneously in 11 veins and persisted in 1 vein at 1-week follow-up. The venous diameter significantly decreased the day after the procedure (8.7 ± 1.2 mm vs 5.3 ± 1.5 mm, P < 0.001), but recovered by the 1-week follow-up (7.9 ± 1.7 mm, P = 0.07) in the 12 veins. Short-term placement of multiple venous sheaths in a single femoral vein appears to be safe. Nonetheless, nonocclusive DVT does occur in a significant number of patients. Although thrombosis regressed and the outcome appeared to be benign in most patients, close follow-up to avoid potential vascular complications is necessary. (Jpn Heart J 2004; 45: 257-264)

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“…has a sensitivity of 95% to 100% and specificity of 98% for the diagnosis of DVT in the femoropopliteal segment; and sensitivity of 80% to 94% and specificity of 75% for the infrapatellar segment 11,12 . The explanation for the lower accuracy of CDUS in the infrapatellar segment may be associated with its greater limitations when examining these veins because of their smaller caliber, the attenuation of edema, and the deeper position of vessels.…”

Section: Discussionmentioning

confidence: 99%

Variacoes anatomicas dos vasos tibiais: diagnostico diferencial de trombose venosa profunda antiga pela ecografia vascular

et al. 2013

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Background: Even though color Doppler ultrasound (CDUS) imaging is reliable in assessing deep vein thrombosis (DVT) in lower extremities, anatomical variations of tibial veins may limit the diagnosis and even lead to false positive results. Objective: To describe anatomic variations of the posterior tibial vein that may lead to false positive results in the CDUS diagnosis of chronic DVT. Methods: CDUS scans of patients with suspected deep vein thrombosis of the lower extremities obtained from January to December 2012 were reviewed to record the presence, number and course of deep veins and arteries. Suspected anatomic variations of the posterior tibial veins were reviewed by another vascular sonographer to confirm findings. Anatomic variations, such as absence or hypoplasia of the posterior tibial veins, were recorded when the posterior tibial artery was not detected in any segments, as well as when the artery was also not visualized in the same segments. Results: A total of 1458 CDUS scans of patients with suspected DVT in the lower extremities were reviewed. In six patients (0.41%), the posterior tibial veins were absent or hypoplastic. Scans were unilateral for five patients and bilateral for one, at a total of 7 lower extremities (3 right and 4 left). Conclusion: Although a rare condition, found in only 0.41% of the cases, awareness of posterior vein absence may help to avoid misdiagnoses and false-positive results of DVT in patients with this variation.

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Venous Duplex Imaging for the Diagnosis of Acute Deep Venous Thrombosis

Cited by 33 publications

References 14 publications

Venous thrombus stability during acute phase of therapy

Venous thrombus stability during acute phase of therapy

Safety and Outcomes of Short-Term Multiple Femoral Venous Sheath Placement in Cardiac Electrophysiological Study and Radiofrequency Catheter Ablation

Variacoes anatomicas dos vasos tibiais: diagnostico diferencial de trombose venosa profunda antiga pela ecografia vascular

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