ORIGINAL ARTICLES   

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

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

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.