[D-dimer determination in suspected deep venous thrombosis or lung embolism]

Cleavage of crosslinked fibrin by the fibrinolytic enzyme plasmin leads to the formation of fibrin degradation products, among them D-dimers. D-Dimer can easily be measured in plasma or in whole blood by means of monoclonal antibodies directed against epitopes of the D-dimer fragment. Elevated plasma levels of D-dimers are characteristic for patients with venous thromboembolism (DVT, PE), but occur also in patients with infectious diseases, malignant neoplasms and heart failure. Given the high sensitivity of ELISA D-dimer assays with respect to venous thromboembolism it is possible to reliably rule out DVT or PE when the plasma concentration of D-dimer is below the cut-off level. Thus, it is possible to rule out DVT in about 30% of outpatients with suspected venous thromboembolism by the measurement of D-dimer-concentration with a validated assay avoiding further diagnostic procedures.