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A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
10:26

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis

Published on: June 2, 2015

Combined D-dimer and clinical probability are useful for exclusion of recurrent deep venous thrombosis

Carlos Aguilar1, Valentin del Villar

  • 1Department of Haematology, Hospital General Santa Bárbara, Soria, Spain. caraguilar@excite.com

American Journal of Hematology
|September 2, 2006
PubMed

Insights

A diagnostic algorithm using D-dimer (DD) and clinical assessment effectively rules out recurrent deep venous thrombosis (DVT) in outpatients. This approach is particularly safe and useful for patients with a low pretest probability of DVT.

Area of Science:

  • Vascular Medicine
  • Diagnostic Imaging
  • Clinical Pathology

Background:

  • Recurrent deep venous thrombosis (DVT) affects up to one-third of patients with a history of DVT.
  • Accurate diagnosis of acute recurrent DVT in outpatients is crucial for appropriate management.
  • Standard diagnostic algorithms require evaluation for efficacy in recurrent DVT scenarios.

Purpose of the Study:

  • To assess the diagnostic value of D-dimer (DD) in suspected acute recurrent DVT.
  • To evaluate the safety and utility of a diagnostic algorithm combining clinical assessment, plasma DD levels, and compression venous ultrasound.
  • To determine the effectiveness of this strategy in an outpatient setting.

Main Methods:

  • 105 outpatients with a history of DVT and suspected recurrent DVT were enrolled.
  • A diagnostic algorithm including clinical assessment, plasma DD levels, and compression venous ultrasound was applied.
  • Patients with initially excluded DVT underwent a 3-month follow-up.

Main Results:

  • The prevalence of DVT in the study population was 44.8%.
  • A negative DD result ruled out DVT in 15.2% of patients with unlikely clinical probability.
  • The D-dimer test demonstrated a sensitivity of 97.9% and a negative predictive value of 94.4% for DVT diagnosis.

Conclusions:

  • A diagnostic strategy combining clinical evaluation and D-dimer is effective for excluding DVT in patients with suspected recurrent DVT.
  • This approach is especially beneficial for outpatients with a low clinical pretest probability of recurrent DVT.
  • The standard diagnostic algorithm is safe and useful for managing suspected acute recurrent DVT in this population.

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