Does Repeat Duplex Ultrasound for Lower Extremity Deep Vein Thrombosis Influence Patient Management?

The clinical significance of lower extremity deep vein thrombus (DVT) propagation in the setting of anticoagulation therapy remains unclear. The purpose of this study is to compare results of thrombus outcome found with repeat duplex ultrasonography to the incidence of pulmonary embolism and mortali...

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Bibliographic Details
Published in:Vascular and endovascular surgery 2004-11, Vol.38 (6), p.525-531
Main Authors: Ascher, Enrico, DePippo, Patrick S., Hingorani, A., Yorkovich, W., Salles-Cunha, S.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Cardiovascular system
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Lower Extremity
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Ultrasonic investigative techniques
Ultrasonography, Doppler, Duplex
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
Vena Cava Filters
Venous Thrombosis - diagnosis
Venous Thrombosis - diagnostic imaging
Venous Thrombosis - therapy
Ventilation-Perfusion Ratio
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Summary:The clinical significance of lower extremity deep vein thrombus (DVT) propagation in the setting of anticoagulation therapy remains unclear. The purpose of this study is to compare results of thrombus outcome found with repeat duplex ultrasonography to the incidence of pulmonary embolism and mortality. During a recent 18-month period, 457 patients were diagnosed with lower extremity DVT with duplex ultrasonography and their data were retrospectively analyzed. Repeat examinations were available for review in 118 patients (51 men, 67 women). Results of repeat duplex exams were divided into 4 groups: resolved, improved, unchanged, or extended proximally. All patients received heparin and warfarin therapy. Ventilation-perfusion (V./Q.) scans were obtained only for signs and symptoms of pulmonary embolism (n=30). Mortality, the prevalence of high-probability V./Q. scans, frequency of intracaval-filter insertion, gender, mean age, mean prothrombin time (PT), mean partial thromboplastin time (PTT), mean number of repeat ultrasounds per patient, and mean time over which the repeat ultrasounds took place were compared among the 4 groups. Patients who had proximal extension of DVT (19%) on repeat duplex ultrasound had an increased prevalence of pulmonary embolism (p
ISSN:1538-5744
1938-9116
DOI:10.1177/153857440403800606