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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 2008 Ottobre;27(5):377-84
The role of duplex ultrasonography in the diagnosis of lower-extremity deep vein thrombosis in non-hospitalized patients
Seidel A. C. 1, Cavalheri G. Jr. 2, Miranda F. Jr. 3
1 Department of Medicine, Maringá State University, Maringá, Paraná, Brazil
2 Med Imagem Ultrasonography Laboratory, Maringá, Paraná, Brazil
3 Surgery Department, São Paulo Federal University, São Paulo, Brazil
Aim. The aim of this study is to reassess the diagnostic evaluation using duplex scanning in non-hospitalized patients, suspected of having deep vein thrombosis (DVT) of the lower limbs.
Methods. In a period of 4 years, 589 patients suspected of having DVT of the lower limbs were submitted to duplex scanning for diagnostic confirmation. The patient complaints were pain, edema or color alteration of the extremity, associated with a risk factor or not. The time span between the beginning of symptoms and the ultrasound was considered as well, with the examination being conducted only on the member that presented the signs or symptoms, or on both in case of suspicion of pulmonary embolism. This study features 203 male patients and 386 female patients, aged 19 to 93.
Results. In Group I, of the 139 patients who displayed acute venous thrombosis (N=77), 55.4% had at least one associated risk factor; in Group II, of the 96 patients with chronic thrombosis (N=72), 75% had an associated risk factor that predominated the previous history of illness; and in Group III, in 354 patients without DVT, 161 of them (45.5%) featured some associated risk factor.
Conclusion. It was concluded that duplex scanning is a useful tool for offering a prompt and efficient diagnosis of venous thrombosis as well as displaying alterations in adjacent structures, thus facilitating the differential diagnostic with other conditions, although in many patients (32.7%) the examination was done unnecessarily, with irrelevant clinical signs and in the absence of any evident risk factor.