Ultrasonic Diagnosis of Iliofemoral Venous Thrombosis: Merits and Disadvantages

Abstract

Twenty-nine patients with clinical suspicion of iliofemoral venous thrombosis were investigated by duplex-Doppler ultrasound and phlebography. Twenty-two of the patients were proven to have thrombosis in one of the lower limbs by both duplex-Doppler ultrasound and phlebology. Of these, 19 patients had iliofemoral thrombosis. The upper end of the thrombus could be demonstrated with ultrasound in only two patients. It is concluded that duplex-Doppler ultrasound is very reliable for the diagnosis of the thrombotic condition but that for proper determination of the upper end of an iliofemoral thrombosis phlebography is still needed, especially if operative treatment is contemplated.

Phlebographic Appearance of Lower-Extremity Deep-Vein Thrombosis: Special Reference to Extent, Distribution and Age of Thrombosis

“…DVT extension above the inguinal liga ment occurred in 12 cases in our material (33%) and since it is in this group of patients that one expects a greater risk for pulmonary embolism, it is reassuring that earlier studies 41 show a good correlation between US and phle bography in the diagnostic accuracy of DVT per se, even if determination of the age of the thrombus and the exact extension remain problematic [18]. This is important to bear in mind should intervention be contemplated (thrombectomy or IVC interruption).…”

“…The current trend in lower-extremity DVT diagnosis is to perform US initially, with or without Doppler assistance, and then use phlebography as a backup in cases when addi tional information is needed (calf DVT, in volvement of the inferior vena cava (IVC) in iliofemoral DVT) [9,18]. In our material, a total of 96 acute thromboses were found in the calf without involvement of the popliteal vein (26%).…”