Skip to main content

Venous Duplex Ultrasound of the Lower Extremity in the Diagnosis of Deep Venous Thrombosis

  • Chapter
Noninvasive Vascular Diagnosis

Abstract

Duplex ultrasonography has dominated the clinical landscape for the diagnosis of acute deep venous thrombosis (DVT) since the early 1990s with utilization increasing in both the outpatient and inpatient milieu. Although this modality was initially flawed by high cost, cumbersome size, and low resolution, advancing technology has eliminated many of the early objections to the point where ultrasound has become the diagnostic test of choice. The recent advent of low cost, compact color duplex machines now enables even small laboratories and physician offices to play a larger clinical role in the diagnosis of and treatment for DVT.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Zierler BK. Screening for acute DVT: optimal utilization of the vascular diagnostic laboratory. Semin Vasc Surg 2001;14:206–214.

    Article  PubMed  CAS  Google Scholar 

  2. Greenfield LJ. Venous thrombosis and pulmonary thromboembolism. In: Greenfield LJ, Mulholland M, Oldham KT, Zelenock GB, Lillemore KD (eds). Surgery: Scientific Principles and Practice, 2nd ed. Philadelphia: Lippincott-Raven Publishers, 1997.

    Google Scholar 

  3. Hull MB, Pineo GF. Prophylaxis of deep venous thrombosis and pulmonary embolism. Current recommendations. Med Clin North Am 1998;82:477–493.

    Article  PubMed  CAS  Google Scholar 

  4. Arfvidsson B, Eklof B, Kistner RL, et al. Risk factors for venous thromboembolism following prolonged air travel. Coach class thrombosis. Hematol Oncol Clin North Am 2000;14:391–400.

    Article  PubMed  CAS  Google Scholar 

  5. Stein PD, Hull RD, Ghali WA, et al. Tracking the uptake of evidence: Two decades of hospital practice trends for diagnosing deep vein thrombosis and pulmonary embolism. Arch Intern Med 2003;163:1213–1219.

    Article  PubMed  Google Scholar 

  6. Borst-Krafek B, Fink AM, Lipp C, Umek H, Kohn H, Steiner A. The proximal extent of pelvic vein thrombosis and its association with pulmonary embolism. J Vasc Surg 2003;37:518–522.

    Article  PubMed  Google Scholar 

  7. Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism: A controlled study. Lancet 1960;1:1309–1312.

    Article  PubMed  CAS  Google Scholar 

  8. Kearon C. Natural history of venous thromboembolism Circulation 2003;107:I22–I30.

    Google Scholar 

  9. Ascher E, DePippo PS, Hingorani A, Yorkovich W, Salles-Cunha S. Does repeat duplex ultrasound for lower extremity deep vein thrombosis influence patient management? Vasc Endovasc Surg 2004;38:525–531.

    Article  Google Scholar 

  10. Passman MA, Moneta GL, Taylor LM Jr, et al. Pulmonary embolism is associated with the combination of isolated calf vein thrombosis and respiratory symptoms. J Vasc Surg 1997;25:39–45.

    Article  PubMed  CAS  Google Scholar 

  11. Kazmers A, Groehn H, Meeker C. Acute calf vein thrombosis. Am Surg 1999;65:1124–1127.

    PubMed  CAS  Google Scholar 

  12. Ohgi S, Tachibana M, Ikebuchi M, et al. Pulmonary embolism in patients with isolate soleal vein thrombosis. Angiology 1998;49:759–764.

    Article  PubMed  CAS  Google Scholar 

  13. Holmstrom M, Lindmarker P, Granqvist S, et al. A 6-month venographic follow-up in 164 patients with acute deep vein thrombosis. Thromb Haemost 1997;78:803–807.

    PubMed  CAS  Google Scholar 

  14. Goodacre S, Sutton AJ, Sampson FC. Meta-analysis: The value of clinical assessment in the diagnosis of deep venous thrombosis. Ann Intern Med 2005;143:129–139.

    PubMed  Google Scholar 

  15. Wells PS, Hirsh J, Anderson DR, et al. Accuracy of clinical assessment of deep-vein thrombosis. Lancet 1995;345:1326–1330.

    Article  PubMed  CAS  Google Scholar 

  16. Talbot SR, Oliver MA. Techniques of Venous Imaging. Pasadena, CA: Appleton Davies, 1992.

    Google Scholar 

  17. Hyers TM, Agnelli G, Hull RD, et al. Antithrombotic therapy for venous thromboembolic disease. Chest 2001;119:176S–193S.

    Article  PubMed  CAS  Google Scholar 

  18. Kearon C, Julian JA, Math M, et al. Noninvasive diagnosis of deep vein thrombosis. McMaster Diagnostic Imaging Practice Guidelines Initiative. Ann Intern Med 1998;128:663–677.

    PubMed  CAS  Google Scholar 

  19. American College of Emergency Physicians (ACEP), Clinical Policies Committee and the Clinical Policies Subcommittee on Suspected Lower-Extremity Deep Venous Thrombosis. Clinical policy: Critical issues in the evaluation and management of adult patients presenting with suspected lower-extremity deep venous thrombosis. Ann Emerg Med 2003;42:124–135.

    Article  Google Scholar 

  20. Rose SC, Zwiebel WJ, Nelson BD, et al. Symptomatic lower extremity deep venous thrombosis: Accuracy, limitations, and role. Radiology 1990;175:639–644.

    PubMed  CAS  Google Scholar 

  21. Bradley MJ, Spencer PA, Alexander L, et al. Colour flow mapping in the diagnosis of the calf deep vein thrombosis. Clin Radiol 1993;47:399–402.

    Article  PubMed  CAS  Google Scholar 

  22. Mattos MA, Londrey GL, Leutz DW, et al. Color-flow duplex scanning for the surveillance and diagnosis of acute deep venous thrombosis. J Vasc Surg 1992;15:366–375.

    Article  PubMed  CAS  Google Scholar 

  23. Borris LC. Comparison of real-time B-mode ultrasonography and bilateral ascending phlebography for detection of postoperative deep vein thrombosis following elective hip surgery. The Venous Thrombosis Group. Thromb Haemost 1989;61:363–365.

    PubMed  CAS  Google Scholar 

  24. Zierler BK. Ultrasonography and diagnosis of venous thromboembolism. Circulation 2004;109:I9–I14.

    Article  PubMed  Google Scholar 

  25. O’Shaughnessy AM, Fitzgerald DE. The value of duplex ultrasound in the follow-up of acute calf vein thrombosis. Int Angiol 1997;16:142–146.

    PubMed  CAS  Google Scholar 

  26. Zierler BK, Meissner MH, Cain K, Strandness DE. A survey of physicians’ knowledge and management of venous thromboembolism. Vasc Endovasc Surg 2002;36:367–375.

    Article  Google Scholar 

  27. Comerota AJ. Myths, mystique, and misconceptions of venous disease. J Vasc Surg 2001;34:765–773.

    Article  PubMed  CAS  Google Scholar 

  28. Blebea, J, Kihara TK, Neumyer MM, Blebea JS, Anderson KM, Atnip RG. A national survey of practice patterns in the noninvasive diagnosis of deep venous thrombosis. J Vasc Surg 1999;29:799–806.

    Article  PubMed  CAS  Google Scholar 

  29. Garcia ND, Morasch MD, Ebaugh JL, et al. Is bilateral ultrasound scanning of the legs necessary for patients with unilateral symptoms of deep vein thrombosis? J Vasc Surg 2001;34:792–797.

    Article  PubMed  CAS  Google Scholar 

  30. Hirsch AT, Zierler ER, Bendick PJ. Commentary re: A national survey of practice patterns in the noninvasive diagnosis of deep venous thrombosis. J Vasc Surg 1999;29:939–940.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag London Limited

About this chapter

Cite this chapter

Mintz, B.L., Araki, C.T., Kritharis, A., Hobson, R.W. (2007). Venous Duplex Ultrasound of the Lower Extremity in the Diagnosis of Deep Venous Thrombosis. In: AbuRahma, A.F., Bergan, J.J. (eds) Noninvasive Vascular Diagnosis. Springer, London. https://doi.org/10.1007/978-1-84628-450-2_35

Download citation

  • DOI: https://doi.org/10.1007/978-1-84628-450-2_35

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-446-5

  • Online ISBN: 978-1-84628-450-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics