Rapid D-Dimer Assays to Exclude Deep Venous Thrombosis and Pulmonary Embolism: Current Status and New Developments

Janssen, Mirian C. H.; Wollersheim, Hub; Verbruggen, Bert; Nováková, I.R.O.

doi:10.1055/s-2007-996028

Cited by 46 publications

(35 citation statements)

References 38 publications

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“…Much emphasis in current clinical practice is placed on the diagnosis of DVT owing to the serious risk of pulmonary embolism. 1 The sophisticated use of risk stratification models, D-dimer measurement, and Duplex venous studies correctly identifies most DVTs. However, a number of musculoskeletal disorders may present with a similar clinical picture and require careful evaluation in order to avoid inappropriate investigation and management.…”

Section: Discussionmentioning

confidence: 99%

Differential diagnosis of calf pain with musculoskeletal ultrasound imaging

Kane

Bálint

Gibney

et al. 2004

Annals of the Rheumatic Diseases

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Section: Discussionmentioning

confidence: 99%

Differential diagnosis of calf pain with musculoskeletal ultrasound imaging

Kane

Bálint

Gibney

et al. 2004

Annals of the Rheumatic Diseases

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“…Owing to the fact that deep vein thrombosis and pulmonary embolism often occur at the same time and up to 50% of patients with deep vein thrombosis have clinically inapparent pulmonary embolism, d -dimer levels can be used similarly in patients with deep vein thrombosis and pulmonary embolism 17. Therefore, the d -dimer test as a fast and cost-effective method is recommended in suspected pulmonary embolism.…”

Section: Value Of D-dimer Measurement In Pulmonary Embolismmentioning

confidence: 99%

Impact of D-Dimers on the Differential Diagnosis of Acute Chest Pain: Current Aspects besides the Widely Known

Hahne

Lebiedz

Breuckmann

2014

Clin Med Insights Cardiol

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d-dimers are cleavage products of fibrin that occur during plasmin-mediated fibrinolysis of blood clots. In the emergency department, d-dimer measurement represents a valuable and cost-effective tool in the differential diagnosis of acute chest pain including the main life-threatening entities: acute coronary syndrome, pulmonary embolism, and acute aortic syndrome. Whereas the diagnostic and prognostic values of d-dimer testing in acute coronary syndrome is of less priority, increases of d-dimers are frequently found in venous thromboembolism and acute aortic syndromes, especially acute aortic dissection. As to the high negative predictive value of d-dimer in those disorders, patients with low to intermediate pretest probability may profit in terms of less necessity of further non-invasive or even invasive imaging, simultaneously reducing potential complications and healthcare-related costs. However, because of the low specificity of the different d-dimer tests in contrast to its frequent usage, adequate interpretation is required. Age-related adjustment of d-dimer levels may be used to increase its diagnostic power.

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“…39,[41][42][43][44][45] The reference standards for diagnosis are ascending contrast venography and pulmonary angiography, respectively. Impedance plethysmography, Doppler flow analysis, and radiolabeled fibrinogen uptake have been replaced by compression ultrasound (CUS) and color flow Duplex imaging for DVT.…”

Section: I a G N O S T I C M O D A L I T I E Smentioning

confidence: 99%

“…Janssen et al, 41,43 Freyburger et al, 42 de Moerloose et al, 81 D'Angelo et al, 82 Reber et al, 83 and Perrier et al 84,85 have analyzed application of the automated rapid ELISA (VIDAS) D-Dimer assay for the exclusion of venous thromboembolism. Remarkably, 99.5% to 100% negative predictive value was determined for the exclusion of DVT and PE.…”

Section: A B O R a T O R Y E V A L U A T I O Nmentioning

confidence: 99%

Diagnosis of deep vein thrombosis and pulmonary embolism

Baker

2000

Compr Ther

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The diagnostic evaluation of the patient with suspected deep vein thrombosis (DVT) and pulmonary embolism (PE) is rapidly changing as the result of clinical studies that clarify the relationship between clinical features and the results of laboratory and imaging studies. The history and physical examination determine a clinical probability, which guides test selection and interpretation. Newly available diagnostic modalities allow greater diagnostic accuracy, lower cost, and greater convenience. New algorithms combine clinical features, the rapid ELISA (VIDAS) D-Dimer assay, compression ultrasonography, the ventilation/perfusion lung scan and spiral computed tomographic imaging.Morbidity and mortality studies indicate that 73% of PE diagnosed at autopsy were not detected clinically 1 and that PE has a mortality rate of 18% to 30% without treatment. 2 Over 90% of PE arise from DVT, and as many as 50% of patients with leg symptoms are proven to have a diagnosis other than DVT. 3-6 Classic symptoms for PE, such as pleuritic chest pain and hemoptysis, are not particularly useful in establishing the diagnosis of PE. 2 Clinical features alone are inadequate.Although often viewed as distinct clinical entities, DVT and PE represent manifestations of a continuum of disease. Over 50% of cases 7 of PE may not have recognized sources of DVT. Many patients with proximal DVT have clinically silent PE. Symptomatic thrombi are usually found in proximal veins 8,9 ; however, at least 50% of PE occurs in asymptomatic patients. 10 While the majority of DVT occurs in infrapopliteal veins, the primary source of PE is proximal DVT. 3,11-12 Calf DVT propagates proximally in about 20% to 30% of cases. 12 Predisposition to venous thromboembolic disease results from specific clinical conditions and hereditary and acquired blood defects. [13][14][15][16][17] High clinical probability occurs in malignancy, stasis, the postop-Traditional approaches to diagnosis of deep vein thrombosis and pulmonary embolism are primarily based on the results of compression ultrasonography and the ventilation/perfusion lung scan (V/Q). Spiral computed tomographic imaging may replace the V/Q scan, and the D-Dimer assay may guide evaluation.

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Rapid D-Dimer Assays to Exclude Deep Venous Thrombosis and Pulmonary Embolism: Current Status and New Developments

Cited by 46 publications

References 38 publications

Differential diagnosis of calf pain with musculoskeletal ultrasound imaging

Differential diagnosis of calf pain with musculoskeletal ultrasound imaging

Impact of D-Dimers on the Differential Diagnosis of Acute Chest Pain: Current Aspects besides the Widely Known

Diagnosis of deep vein thrombosis and pulmonary embolism

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