Elsevier

European Journal of Radiology

Volume 13, Issue 3, November–December 1991, Pages 174-177
European Journal of Radiology

Original article
Influence of negative ultrasound findings on the management of in- and outpatients with suspected deep-vein thrombosis

https://doi.org/10.1016/0720-048X(91)90023-OGet rights and content

Abstract

Real-time ultrasonography (US) was used as a single non-invasive method in the management of 174 patients (56 inpatients and 118 outpatients) with suspected deep-vein thrombosis (DVT). Therapeutic decisions were based on the results of ultrasonography alone. If the US examination was abnormal anticoagulant treatment was started. If the initial US examination was normal, no treatment was given and the patient underwent repeated testing and physical examination after 1 day, 7 days and 3 months. In the outpatient group, 1.3% of the ultrasonographic negative patients developed thromboembolic complications (95% confidence limits, 0.03–7.21%). None of the initial ultrasonographic negative patients developed proximal DVT after 1 day and 7 days. In the inpatient group, 10% of the ultrasonographic negative patients developed thromboembolic complications (95% confidence limits, 1.2–31.7%). In 18% of the ultrasonographic negative patients an alternative, unexpected diagnosis was obtained by ultrasound. The most frequent alternative diagnosis was a popliteal cyst. The results indicate that US alone appears to be a safe diagnostic method in the management of outpatients with suspected DVT. In the inpatient group further research is required for definite recommendations regarding a safe ultrasound follow-up schedule.

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Cited by (39)

  • Outcomes for Inpatients with Normal Findings on Whole-leg Ultrasonography: A Prospective Study

    2010, American Journal of Medicine
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    Although convenient in routine practice, whole-leg ultrasonography remains controversial because of a probably outdated perception that ultrasonography is inaccurate in detecting calf thrombi.21,22 Actually, our estimate of 3-month venous thromboembolism in untreated inpatients was consistent with those observed in studies using repeated compression ultrasonography of proximal veins (1.8% [95% CI, 0.2-6.4]20 and 10% [95% CI, 1.2-31]19). There also is growing evidence that whole-leg ultrasonography is equivalent to repeated compression ultrasonography of proximal veins for excluding deep vein thrombosis in the outpatient setting.8

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    1999, Bailliere's Best Practice and Research in Clinical Haematology
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