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Clinically important pulmonary emboli: does calf vein US alter outcomes?
R H Gottlieb1, J Widjaja, S Mehra
1Department of Radiology, University of Rochester Medical Center, NY 14642, USA.
Radiology
|April 6, 1999
Summary
Calf ultrasonography is not needed when initial thigh scans for deep venous thrombosis (DVT) are negative. This avoids unnecessary imaging and focuses on patients at risk for pulmonary embolism (PE) or DVT propagation.
Area of Science:
- Radiology
- Vascular Imaging
- Thrombosis Research
Background:
- Deep venous thrombosis (DVT) is a significant cause of morbidity and mortality.
- Pulmonary embolism (PE) is a major complication of DVT.
- Lower extremity ultrasonography (US) is a primary diagnostic tool for DVT.
Purpose of the Study:
- To determine if calf US is necessary for identifying patients at risk of clinically important PE or DVT propagation when initial thigh US is negative.
- To evaluate the necessity of calf imaging in the diagnostic workup of suspected lower extremity DVT.
Main Methods:
- Retrospective analysis of 283 patients with negative initial thigh US for DVT.
- Evaluation of radiology reports, patient demographics, risk factors (including surgery), and anticoagulation status.
- Classification of adverse outcomes as clinically important PE or thigh DVT.
Main Results:
- Only 1.1% of patients experienced adverse outcomes (PE or thigh DVT).
- Adverse outcomes were exclusively observed in postsurgical patients (P = .028).
- Calf DVT presence or absence and treatment method did not correlate with adverse outcomes.
Conclusions:
- Calf ultrasonography is unnecessary during the initial evaluation for patients with negative thigh US findings for DVT.
- Focusing on thigh US alone can effectively identify patients at risk for PE or DVT propagation.
- This finding can streamline diagnostic protocols and reduce unnecessary imaging.