Two-point Compression Ultrasound Technique Risks Missing Isolated Femoral Vein DVTs

• Published in: The western journal of emergency medicine 2022-06, Vol.23 (4), p.597-600
• Main Authors: Tabbut, Matthew, Ebersole, Nate, Icken, Lauren, Jones, Robert, Gramer, Diane
• Format: Article
• Language: English
• Subjects: Technology; Ultrasonic imaging
• ISSN: 1936-900X; 1936-9018; 1936-9018
• DOI: 10.5811/westjem.2022.2.53830

Background: Deep vein thrombosis (DVT) is a common vascular problem seen in the emergency department (ED) and is commonly identified using ultrasound performed by a vascular lab, the radiology department, or at the point of care. Previous studies have assessed the utility of a two-point vs sequential technique to identify the presence of a thrombus. One particular study reported a concerning rate of isolated femoral vein thrombi that would be missed by a two-point technique. Objectives: In this study we sought to determine whether the two-point technique misses isolated femoral vein thrombi. Methods: We conducted a retrospective review of patients who had a new diagnosis of DVT in the ED diagnosed with vascular lab, radiology, or point-of-care ultrasound to assess for the presence and rate of thrombi that would be missed using a two-point scanning technique. Results: We included in our study 356 patients with a diagnosis of new DVT. In our population, 21 (5.9%; 0.95 confidence interval: 3.7%, 8.9%) patients were identified with thrombi isolated to the femoral vein.Conclusion: The two-point technique for lower extremity vascular ultrasound is insufficient for ruling out proximal DVTs in ED patients.