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Updated: Feb 15, 2026
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A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
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Below-knee deep vein thrombosis (DVT): diagnostic and treatment patterns
Drew Fleck1, Hassan Albadawi1, Alex Wallace1
1Division of Interventional Radiology, Mayo Clinic, Phoenix, AZ, USA.
Cardiovascular Diagnosis and Therapy
|February 6, 2018
Summary
Most below-knee deep vein thrombosis (BKDVT) patients receive anticoagulation, despite variable clinical practice and radiology reports influencing treatment decisions. Surveillance is underutilized for BKDVT.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Clinical Decision-Making
Background:
- Lack of clear guidelines for isolated below-knee deep vein thrombosis (BKDVT).
- Variable clinical practice and underutilization of surveillance despite ACCP recommendations.
- Limited understanding of BKDVT natural history and optimal management.
Purpose of the Study:
- To analyze treatment patterns and outcomes for isolated below-knee deep vein thrombosis (BKDVT).
- To assess the influence of clinical risk factors and radiology report language on treatment decisions.
- To evaluate the utilization of surveillance in BKDVT management.
Main Methods:
- Retrospective analysis of 102 medical records (2014-2016) for isolated BKDVT.
- Assessment of risk factors (age, gender, malignancy, surgery, DVT history).
- Correlation of risk factors and radiology report clarity with treatment decisions and outcomes using chi-square and logistic regression.
Main Results:
- 17.6% of BKDVT patients had concurrent pulmonary embolism (PE); malignancy was associated with PE.
- Treatment decisions were not linked to clinical risk factors but were significantly influenced by radiology report language.
- Approximately 90% of patients received anticoagulation, with surveillance rarely recommended or utilized.
Conclusions:
- High rates of anticoagulation for BKDVT, often irrespective of clinical risk factors.
- Variable radiology reporting significantly impacts treatment decisions, highlighting a need for standardized terminology.
- Surveillance for BKDVT appears underutilized, warranting further investigation into its role.
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