Deep vein thrombosis – the role of ultrasound in the diagnosis and follow-up of patients

Czech version

Authors: Tomáš Hauer ^1,2,3
Authors‘ workplace: Cévní Centrum České Budějovice, s. r. o. ¹; Cévní program, Nemocnice České Budějovice, a. s. ²; Kardiologická klinika, Fakultní nemocnice Královské Vinohrady a 3. lékařská fakulta Univerzity Karlovy, Praha ³
Published in: Vnitř Lék 2023; 69(4): 244-248
Category: Main Topic
doi: https://doi.org/10.36290/vnl.2023.046

Overview

Deep vein thrombosis still represents a challenge regarding the diagnostics, treatment and follow-up. All this steps are often performed in the internal medicine ambulatory centers and such clinics therefore need to be aable to manage the whole process. Its key part is vascular sonography, which is needed to establish the diagnosis, the form of thrombosis and proper treatment course. There are two types of vascular sonography - Point of Care a expert sonography, being performed in two different regimes (diagnostic and follow up sonography). There are different demands for each of these two types, and each type is performed by physicians with different level of expertise. There are well defined criteria for performance a conclusions made for each type, and their precise fulfillment leads to establishment of diagnosis of DVT, early treatment initiation and setting of optimal strategy following the baseline treatment period.

Keywords:

follow-up – Deep vein thrombosis – Pulmonary embolism – vascular sonography – point-of-care examination – espert sonography

Sources

1. Cohen AT, Agnelli G, Anderson FA, et al. VTE Impact Assessment Group in Europe (VITAE). Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007 Oct;98(4):756-64.

2. Goodacre S, Sampson F, Thomas S, et al. Systematic review and meta‑analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis. BMC Med Imaging. 2005 Oct 3;5:6.

3. Kainz B, Heinrich MP, Makropoulos A, et al. Non‑invasive diagnosis of deep vein thrombosis from ultrasound imaging with machine learning. NPJ Digit Med. 2021 Sep 15;4(1):137.

4. Zhang Y, Xia H, Wang Y, et al. The rate of missed diagnosis of lower‑limb DVT by ultrasound amounts to 50% or so in patients without symptoms of DVT: A meta‑analysis. Medicine (Baltimore). 2019 Sep;98(37):e17103.

5. Pulivarthi S, Gurram MK. Effectiveness of d‑dimer as a screening test for venous thromboembolism: an update. N Am J Med Sci. 2014 Oct;6(10):491-9.

6. Barrosse‑Antle ME, Patel KH, Kramer JA, et al. Point‑of‑Care Ultrasound for Bedside Diagnosis of Lower Extremity DVT. Chest. 2021 Nov;160(5):1853-1863.

7. Young L, Ockelford P, Milne D, et al. Post‑treatment residual thrombus increases the risk of recurrent deep vein thrombosis and mortality. J Thromb Haemost. 2006 Sep;4(9):1919-24.