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International Angiology 1998 December;17(4):260-7


language: English

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.

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