Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study

Abstract

Objective: To evaluate the safety of withholding anticoagulant treatment from patients with clinically suspected deep vein thrombosis but normal findings on compression ultrasonography.

Safety of withholding anticoagulation in pregnant women with suspected deep vein thrombosis following negative serial compression ultrasound and iliac vein imaging

“…10 In contrast, in the general population, more than 80% of deep vein thromboses involved calf veins, and iliofemoral deep vein thromboses or isolated iliac veins are uncommon (< 5%). [1][2][3][4] Physiologic changes associated with pregnancy might affect blood flow patterns and normal compressibility of the proximal veins, thereby affecting the diagnostic accuracy of compression ultrasonograpy. This technique cannot be used to detect isolated deep vein thromboses in the iliac vein; these veins are not compressible because of their intrapelvic location.…”

“…First, the specificity of compression ultra- Second, the prevalence of deep vein thrombosis in our cohort was low (as compared with the prevalence seen in studies of men and nonpregnant women [1][2][3][4] ). This could exaggerate the negative predictive value (i.e., the negative predictive value is closer to 100% because the prevalence of the disease is low).…”

“…[1][2][3][4] Although this test is highly sensitive (about 97%) for deep vein thrombosis involving the femoral and popliteal veins, compression ultrasonography is less sensitive for the detection of isolated deep vein thrombosis in the calf. 5 Because proximal propagation of isolated calf deep vein thrombosis occurs in about 20% of cases, serial compression ultrasonography performed over a 7-day period is recommended to definitely exclude such thromboses if the results of the initial compression ultrasound are negative.…”

Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines

“…These results are comparable to those of other radiologic tests to rule out DVT in patients suspected to have the condition. The prevalence of DVT during 3 months of follow-up was 1.9% in patients with negative venography to rule out DVT [58], and 0.5-0.9% in patients with negative duplex ultrasonography to rule out DVT [59][60][61].…”

Risk Assessment in Venous ThromboEmbolism

“…It was developed as a quick and simple emergency tool, in order to give reliable results in cases of suspected DVT [29][30][31][32][33] . It requires only a simple BMode scan of groin and popliteal region (2-points ultrasonography), where observation can be extended to the 3rd order confluence of anterior and posterior tibia and peroneal veins.…”