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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

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Calf deep vein thrombosis - clinical relevance, diagnostic approaches and therapeutic options

Giovanna Elmi1, Elisa Rebecca Rinaldi1, Andrea Domanico1

  • 1Medical Department, Ultrasound Program, Maggiore Hospital, Azienda USL of Bologna, Italy.

VASA. Zeitschrift Fur Gefasskrankheiten
|May 5, 2020
PubMed

Insights

Isolated distal deep vein thromboses (IDDVT) are common but their natural history is unclear. Anticoagulant treatment may be beneficial, but optimal strategies require further research.

Area of Science:

  • Vascular Medicine
  • Hematology
  • Diagnostic Imaging

Background:

  • Isolated distal deep vein thromboses (IDDVT) account for up to 50% of leg deep vein thromboses (DVT).
  • The natural history and optimal management of IDDVT remain subjects of debate.
  • Current diagnostic strategies show limited efficacy for IDDVT.

Purpose of the Study:

  • To review the diagnostic and therapeutic challenges of IDDVT.
  • To synthesize evidence regarding the management of IDDVT.
  • To identify areas for future research in IDDVT.

Main Methods:

  • Review of randomized and observational studies on IDDVT diagnosis and treatment.
  • Analysis of systematic reviews and meta-analyses.
  • Discussion of diagnostic imaging approaches (proximal vs. complete ultrasonography).

Main Results:

  • Diagnostic strategies like pre-test probability and D-dimer have low efficiency for IDDVT.
  • Evidence suggests anticoagulant treatment is beneficial, but optimal dose and duration are undefined.
  • Patient stratification based on risk factors is crucial for therapeutic decisions.

Conclusions:

  • Further research is urgently needed to elucidate the natural history of IDDVT.
  • Studies evaluating lower intensity and shorter duration anticoagulation protocols are essential.
  • Informed patient discussion is paramount in guiding therapeutic choices for IDDVT.

Keywords:
Venous thromboembolismanticoagulationisolated distal deep vein thrombosispre-test probability D-dimerultrasound

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