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Online ISSN 1827-1766
Antignani P. L. 1, Aluigi L. 2
1 Department of Angiology, S. Giovanni Hospital, Rome, Italy;
2 Department of Internal MedicineCentre and School of Ultrasound Applications, Major Hospital, Bologna, Italy
The distal vein thrombosis (DVT) is a special disease poorly studied and actually without consensus on the diagnostic evaluation and on the necessary treatment. Sometimes this disease has a good prognosis, but it can extend to proximal veins and it can progress to pulmonary embolism (PE), especially in its bilateral presentation. The main diagnostic test is colour Duplex Doppler evaluation with compression test, mostly if in experienced hands. Compression ultrasound sonography (CUS) has 88% sensibility and 95% specificity compared to phlebography. Serial ultrasound have two objectives: the first is the diagnosis of distal thrombosis, the second is the evaluation of thrombosis progression to proximal vein. The natural history of this disease is poorly documented and there is no consensus on the necessity of screening and treating patients presenting with isolated distal DVT. Some authors use oral anticoagulants, others prefer serial echo-colour-Doppler before starting therapy. Recent clinical evidences suggest the use of low molecular weight heparin.