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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
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A Study of Risk Factors of Chronic Venous Insufficiency and its Association with Features Suggestive of Preceding or

Ram H Malkani1, Rusina Karia1, Sneh Thadani1

  • 1Department of Dermatology, Jaslok Hospital, Mumbai, Maharashtra, India.

Indian Journal of Dermatology
|September 24, 2019
PubMed

Insights

Resolved deep venous thrombosis (DVT) can cause chronic venous insufficiency (CVI). Blood markers like Factor V may indicate past DVT even when ultrasound shows no active thrombosis, aiding CVI diagnosis.

Area of Science:

  • Vascular Medicine
  • Hematology
  • Diagnostic Imaging

Background:

  • Deep venous thrombosis (DVT) can lead to chronic venous insufficiency (CVI) due to valve damage, even after resolution.
  • Identifying markers of resolved DVT is crucial for diagnosing CVI when active thrombosis is absent.

Purpose of the Study:

  • To investigate thrombotic markers and ultrasound findings in patients with CVI symptoms but no active DVT.
  • To determine if specific blood parameters can serve as indicators of previous DVT in CVI patients.

Main Methods:

  • Cross-sectional study of 50 patients with a history of DVT and CVI symptoms.
  • Clinical assessment, color Doppler ultrasound for DVT and venous incompetence, and blood tests including Factor V, D-Dimer, and lipid profiles.
  • Evaluation of venous severity using the Venous Severity Clinical Score (VSCS).

Main Results:

  • Elevated Factor V levels were significantly associated with severe clinical classification and high VSCS scores (P=0.05 and P=0.03, respectively).
  • Perforator abnormalities were more common in patients with high VSCS, primary venous etiology, obstruction/reflux, and severe clinical classification (P<0.0001 to P=0.002).
  • Ultrasound may not detect resolved DVT, but blood markers like Factor V and hyperhomocysteinemia can be suggestive.

Conclusions:

  • Resolved DVT is a significant cause of CVI and may not be evident on ultrasound.
  • Blood parameters such as Factor V and hyperhomocysteinemia can act as proxy markers for current or previous DVT in CVI patients.
  • These markers offer valuable diagnostic insights when active thrombosis is not detected by imaging.
Abstract

Keywords:
Chronic venous insufficiencydeep venous thrombosisserologyultrasonography

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