Deep vein thrombosis of the lower limbs: A retrospective analysis of doppler ultrasound findings

Khaladkar, Sanjay M; Thakkar, Dhaval; Shinde, Kunal; Thakkar, Dolly; Shrotri, Harshawardhan; Kulkarni, Vilas M

doi:10.4103/0975-2870.140449

Cited by 15 publications

(17 citation statements)

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“…In the present series, the most frequently thrombosed lower extremity veins were popliteal, posterior tibial, profunda femoris and CFV; a similar finding was observed by Khaladkar et al 19 Also, we observed a preponderance of left-sided DVT for great saphenous, common iliac, common femoral and PFV similar to what was reported previously by Ouriel et al 9 In our study, 8% cases showed bilateral LL involvement with frequent association of profunda femoris and CFV thrombosis, and these findings are consistent with an earlier report showed the frequency of bilateral LL DVT to be 7% with primary involvement of femoral vein thrombosis. 25 Therefore, we recommend the duplex ultrasonography examination for both limbs in patients identified to have DVT extending to the CFVs.…”

Section: Discussionsupporting

confidence: 92%

“…9 The frequent presenting signs and symptoms in our study include localized tenderness and LL swelling which is consistent with an earlier study reported leg edema and pain to be the most frequent presenting symptom in patients with LL DVT. 19 Cogo et al 20 reported a higher rate of concurrence (99%) of calf vein thrombosis in patients with proximal DVT and observed continuous involvement of proximal and distal veins in the vast majority of cases. It has been observed that most symptomatic DVT cases had proximal venous thrombosis in continuation with calf veins.…”

Section: Discussionmentioning

confidence: 98%

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Clinical implications of the anatomical variation of deep venous thrombosis

et al. 2017

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Introduction Little is known about the anatomic variation and its implication in patients with lower limb deep venous thrombosis (DVT). We studied the clinical presentation, site of thrombosis and risk factors based on the anatomic distribution of lower limb DVT. Methods A retrospective analysis of clinically suspected DVT cases was conducted between 2008 and 2012. DVT was categorized by the location of the thrombosed segment and limb involved. The DVT anatomic segments were assessed according to left-to-right ratio, predisposing factors and clinical presentations. Results A total of 637 patients with DVT were included with a mean age of 50 ± 17 years (51%; females). The most frequently thrombosed segments were popliteal, posterior tibial and profunda femoris veins. DVT was more common at the left side, with a left-to-right ratio of 1.5:1. Bilateral DVT cases (38.5%) had more prior history of DVT as compared to left- (20.3%) and right-sided DVTs (22.6%); p = 0.01. Bilateral DVT was complicated more with post-thrombotic syndrome (leg ulcer) ( p = 0.02). The rates of pulmonary embolism (25%) and mortality (23.1%) were significantly higher for bilateral DVT in comparison to left- and right-sided DVT. Abnormal coagulation profile was significantly associated with posterior tibial DVT (81% vs. 71.4%; p = 0.01) as compared to patients with normal coagulation profile. Conclusion Lower limb DVTs are more common at the left side; however, patients with bilateral DVT have higher frequency of recurrence, post-thrombotic syndrome, pulmonary embolism and mortality. The anatomic segments of DVT show specific distribution depending on the predisposing factors. These findings could improve our understanding of the pathophysiology and management of DVT patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Clinical implications of the anatomical variation of deep venous thrombosis

et al. 2017

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“…In this study, 15 of 35 patients found with DVT had hyperechoic thrombus (42%). The other sonographic characteristic of DVT noted in this study were the same characteristics reported in other studies [ 13 , 14 ].…”

Section: Discussionsupporting

confidence: 89%

Prevalence of lower limb deep venous thrombosis among adult HIV positive patients attending an outpatient clinic at Mulago Hospital

et al. 2018

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BackgroundDeep venous thrombosis (DVT) and its major complication pulmonary embolism (PE) are collectively known as venous thromboembolism. In Uganda, the prevalence of DVT among HIV patients has not been previously published. The aim of the study was to determine the prevalence and sonographic features of lower limb deep venous thrombosis among HIV positive patients on anti-retroviral treatment (ART).MethodsThis was a cross sectional study in which HIV positive patients on ART were recruited from an out-patient HIV clinic at Mulago National Referral Hospital. Patients were randomly selected and enrolled until a sample size of 384 was reached. Study participants underwent compression and Doppler ultrasound studies of both lower limb deep veins using Medison Sonoacer7 ultrasound machine.ResutsWe found a prevalence of DVT of 9.1% (35 of 384 participants) among HIV patients on ART. The prevalence of latent (asymptomatic) DVT was 2.3%. Among 35 patients with DVT, 42.8% had chronic DVT; 31.1% had acute DVT and the rest had latent DVT. Among the risk factors, the odds of occurrence of DVT among patients with prolonged immobility were 4.81 times as high as in those with no prolonged immobility (p = 0.023; OR = 4.81; 95% CI 1.25–18.62). Treatment with second line anti-retroviral therapy (ART) including protease inhibitors (PIs) was associated with higher odds of DVT occurrence compared with first line ART (p = 0.020; OR = 2.38; 95% CI 1.14–4.97). The odds of DVT occurrence in patients with a lower CD4 count (< 200 cells/µl) were 5.36 times as high as in patients with CD4 counts above 500 cells/µl (p = 0.008). About 48.6% patients with DVT had a low risk according to Well’s score.ConclusionDVT was shown in nearly 10% of HIV patients attending an out-patient clinic in an urban setting in Uganda. Risk factors included protease inhibitors in their ART regimen, prolonged immobility, and low CD4 count (< 200 cells/µl). Clinicians should have a low threshold for performing lower limb Doppler ultrasound scan examination on infected HIV patients on ART who are symptomatic for DVT. Therefore, clinicians should consider anti-coagulant prophylaxis and lower deep venous ultrasound screening of patients who are on second line ART regimen with low CD4 cell counts and/or with prolonged immobility or hormonal contraception.

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“…This result was also compatible with a previous study by Khaladkar et al, who reported the predominant distribution of DVT in the SFV (88.5%) than popliteal vein (69.2%) [12]. This also was compatible with the results of De Maeseneer et al, who reported that SFV was the most commonly affected veins (58%) than popliteal vein (56%) [13].…”

Section: Discussionsupporting

confidence: 92%

Deep Venous Thrombosis: Commonly Affected Veins in the Lower Limbs

Alshoabi¹,

Mothanna²

2019

JBM

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Aim and Objectives: This study aimed to record the commonly affected veins in the lower limbs, to compare the affected sides and gender and to correlate the Doppler findings and stages of deep venous thrombosis (DVT). Materials and Methods: A descriptive retrospective study of 46 already diagnosed cases of lower limb DVT. Results: Out of 46 cases of DVT, 71.74% were females. The majority of patients (93.47%) were affected in unilateral lower limb with significant predominance (65.22%) to affect the left lower limb (p < 0.001). The common femoral vein (CFV) was affected in 71.7% of cases. The superficial femoral vein (SFV) was affected in 71.7% of cases. The popliteal vein was affected in 67.4%. The deep femoral vein was affected only in 17.4%. Both CFV and SFV were affected together in 47.8% of cases. Both SFV and popliteal vein were affected together in 50% of cases. The majority of DVT cases (71.1%) were in the acute stage. This study revealed an essential relationship between the acute stage of DVT and distension of the affected veins (p < 0.001) (OR 20.667, 95% CI 3.826 -111.633). It also detected a significant relationship between the acute stage and absence of venous blood flow (p < 0.001) (OR 90.667,. Conclusion: Lower limb deep venous thrombosis affects left lower limb more than right and females more than males. Superficial femoral vein (SFV) and common femoral vein (CFV) are the most common affected veins. Lower limb DVT predominantly present in acute stage with venous distension and absent blood flow.

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Deep vein thrombosis of the lower limbs: A retrospective analysis of doppler ultrasound findings

Cited by 15 publications

References 0 publications

Clinical implications of the anatomical variation of deep venous thrombosis

Clinical implications of the anatomical variation of deep venous thrombosis

Prevalence of lower limb deep venous thrombosis among adult HIV positive patients attending an outpatient clinic at Mulago Hospital

Deep Venous Thrombosis: Commonly Affected Veins in the Lower Limbs

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