Triplex us in the diagnosis of asymptomatic deep venous thrombosis

Mantoni, Margit; Strandberg, Charlotte; Neergaard, K. v.; Sloth, Carsten; Jørgensen, Per Schultz; Thamsen, H.; Tørholm, C; Paaske, B. P.; Rasmussen, Søren Wistisen; Christensen, Sofie K.; Wille‐Jørgensen, Peer

doi:10.1080/02841859709172073

Cited by 16 publications

(6 citation statements)

References 16 publications

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“… no analyses of bleeding complications due to heterogeneity between the method of computing and the fact, that the data were unaccessible for colorectal patients in most studies; Doppler‐ultrasound was permitted as a screening parameter, as it was considered that the limited sensitivity of this type of investigation in asymptomatic patients [31,32] was equally distributed amongst the randomised groups; no analysis of total mortality and/or fatal PE was performed due to lack of data; a few studies with no blinding were incorporated. …”

Section: Discussionmentioning

confidence: 99%

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Systematic review of thromboprophylaxis in colorectal surgery – an update

2005

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Section: Discussionmentioning

confidence: 99%

“…Doppler‐ultrasound was permitted as a screening parameter, as it was considered that the limited sensitivity of this type of investigation in asymptomatic patients [31,32] was equally distributed amongst the randomised groups;…”

Section: Discussionmentioning

confidence: 99%

Systematic review of thromboprophylaxis in colorectal surgery – an update

2005

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“…Presence of a filling defect or abrupt termination of the opaque column are used as criteria for DVT (9). Nevertheless, venography presents several limitations: pain; induction of DVTs in up to 2% (especially when using ionic contrast agents (6)); general reliability, as indicated by kappa agreement coefficients of observers as low as 0.57 (though some are as high as 0.90) (10)(11)(12)(13)(14); and lack of reliability in special cases because of patient contraindication, patient refusal, or technical reasons (6,15).…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the accuracy of ultrasound in the diagnosis of deep venous thrombosis in asymptomatic patients

Kassaï¹,

Boissel²,

Cucherat³

et al. 2004

Thromb Haemost

104

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Evaluation of the accuracy of ultrasound has yielded heterogeneous results. Our objective was to summarize the evidence on the accuracy of ultrasound compared to venography in asymptomatic patients, taking into account the variation due to threshold differences. Searches of journal table of contents, computer databases (Medline, Embase, Biomed, Cochrane) and conference proceedings were performed. A study was eligible if it prospectively compared ultrasound to venography for the diagnosis of DVT in asymptomatic patients. Data of studies selected for inclusion were extracted independently by two authors. High quality studies with consecutive patient enrollment, blind evaluation of the two techniques, and absence of verification bias are summarized as Level 1, while those not fulfilling one or more of these criteria are considered Level 2. Original study authors were contacted to confirm accuracy and to provide missing data. A pooled estimate of the accuracy of ultrasound was obtained according to the method of Moses and coworkers. This method gives a summary diagnostic odds ratio (DOR). The DOR is a single indicator of test performance. It varies between 0 and infinity and exceeds 1, only when ultrasound is more often positive in patients with DVT relative to those without DVT. Higher DOR indicates better discriminatory test performance. Thirty one studies were rated as potentially unbiased and graded as Level 1. The mean prevalence of DVT as determined by venography was 22%. In Level 1 studies, the odds of positive ultrasound in proximal veins was 379 times higher (95% confidence limits 65, 2,200) and in distal veins 32 times higher (7.5, 135) among patients with DVT than those without. Our results suggest that, particularly for proximal veins, ultrasound is accurate for the diagnosis of DVT in asymptomatic postoperative orthopedic patients. More research is needed in other clinical settings.

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“…Ainda em 1997, Mantoni et al 38 avaliaram 133 pacientes assintomáticos em pós-operatório de fratura de quadril e, comparando o ultra-som com triplex (MD com cor em tempo real) com a flebografia, obtiveram sensibilidade de 74% e especificidade de 99%, com acurácia de 97% quando avaliaram todo o membro inferior. Referiram que, quando o trombo é recente, pode resultar em falso negativo na compressão, mas que a cor demonstra o trombo parcial.…”

Section: Introductionunclassified

“…Entretanto, nas duas revisões acima citadas, não foram avaliados os artigos de Kalodiki et al 37 e Mantoni et al 38 , publicados em 1997. 42 avaliaram 70 pacientes assintomáticos no oitavo dia do pós-operatório de prótese total de quadril, com o MD com cor comparado com a flebografia, em estudo prospectivo.…”

Section: Introductionunclassified

O papel do mapeamento dúplex no diagnóstico da trombose venosa profunda assintomática dos membros inferiores

2005

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O diagnóstico da trombose venosa profunda sintomática está bem estabelecido com o uso do mapeamento dúplex, que apresenta sensibilidade de 100% e especificidade de 98%, para trombose venosa profunda proximal, e sensibilidade de 94% e especificidade de 75%, para distal. Na trombose venosa profunda recente e assintomática, o diagnóstico com o mapeamento dúplex ainda não está bem estabelecido, mostrando uma queda na acurácia desse método diagnóstico. Essa queda é devida ao fato de o trombo recente não ser oclusivo, apresentar a mesma ecogenicidade do sangue e uma consistência diminuída, prejudicando o teste da compressibilidade, que é o mais sensível para diagnóstico da trombose venosa profunda. Nesta revisão, serão revistos artigos publicados que avaliaram a acurácia do mapeamento dúplex no diagnóstico da trombose venosa profunda assintomática.

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Triplex us in the diagnosis of asymptomatic deep venous thrombosis

Abstract: Venous US is less sensitive as a test for DVT in this study of asymptomatic patients than in earlier studies on symptomatic patients. Still, sonographic screening of high-risk patients would be both effective and cost effective. Fresh thrombi may cause a false-negative compression test.

Cited by 16 publications

References 16 publications

Systematic review of thromboprophylaxis in colorectal surgery – an update

Systematic review of thromboprophylaxis in colorectal surgery – an update

A systematic review of the accuracy of ultrasound in the diagnosis of deep venous thrombosis in asymptomatic patients

O papel do mapeamento dúplex no diagnóstico da trombose venosa profunda assintomática dos membros inferiores

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