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Rivista di Angiologia
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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International Angiology 1998 Dicembre;17(4):260-7
Diameters of acute proximal and distal deep venous thrombosis of the lower limbs. Proposed reference values for ultrasonography
Bosson J. L. 1,2, Riachi M. 1, Pichot O. 1, Michoud E. 1, Carpentier P. H. 1, Franco A. 1
From the 1 Department of General Internal Medicine and Angiology 2 Laboratory of Biostatistic, CHU Grenoble, Cedex, France
Background. Duplex ultrasonography of the veins in the diagnosis of deep venous thrombosis (DVT) can be interpreted in a semi-quantitative mode by measuring the antero-posterior (AP) diameter of the thrombus. We report the values of the diameters of thrombi and the factors influencing these values. Therefore we propose a quantitative definition for DVT in duplex ultrasonography.
Methods. 1,017 patients (3,767 thrombosed venous segments), referred to the Emergency Angiology Unit from January 1994 to September 1996. Characteristics: 55% F, 45% M; mean age 68±18 years; 624 proximal DVT (61%) and 393 distal DVT (39%). Measurement by venous echography of the antero-posterior diameters of thrombi at 25 predetermined sites in the area of the vena cava.
Results. (in mm, median, 10th and 90th percentiles after regrouping of contiguous anatomical sites not statistically different): thrombus in the common iliac veins and the inferior vena cava (12 mm, 7-17); external iliac and common femoral veins (9 mm, 5-14); superficial femoral, deep femoral and popliteal veins (6 mm, 4-10); calf veins (5 mm, 4-8). The age of the patients, their sex, body mass index (BMI), whether they were in- or outpatients or the laterality of the thrombus never significantly influenced its diameter.
Conclusions. It is very unusual to observe a diameter of under 5 mm in cases of DVT. For clinical research therefore, we propose 5 mm as the minimum threshold value for this diagnosis. This value could be used in the venous echographic definition of DVT, as a criterion for inclusion in a therapeutic trial, for example, or in an epidemiological study.