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Early diagnosis of iliofemoral venous thrombosis by Doppler examination
S L Hill1, D Martin, E R McDannald
1Department of Surgery, Community Hospital of Roanoke Valley, Virginia.
Insights
Doppler ultrasound is a reliable tool for diagnosing iliofemoral venous thrombosis early. This rapid diagnosis helps prevent serious complications like venous gangrene.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
Background:
- Iliofemoral venous thrombosis diagnosis can be challenging, especially before progression to phlegmasia cerulea dolens.
- Early detection is crucial for effective treatment and complication avoidance.
Purpose of the Study:
- To evaluate the reliability and speed of Doppler ultrasound in diagnosing iliofemoral venous thrombosis.
- To assess the clinical outcomes of patients diagnosed and treated promptly using Doppler ultrasound.
Main Methods:
- Prospective study over 18 months using Doppler ultrasound for iliofemoral venous thrombosis diagnosis.
- Comparison of Doppler ultrasound findings with venograms in a subset of patients.
- Analysis of treatment strategies and patient outcomes.
Main Results:
- Doppler ultrasound diagnosed iliofemoral venous thrombosis in 21 patients; 15 were confirmed by venogram.
- Early diagnosis via Doppler ultrasound prevented progression to venous gangrene or need for surgery in all patients.
- Treatment included streptokinase, heparin, leg elevation, and stockings.
Conclusions:
- Doppler ultrasound is a rapid and reliable method for early iliofemoral venous thrombosis diagnosis.
- Prompt diagnosis and treatment significantly reduce complications.
- Iliofemoral venous thrombosis may be more common than previously thought and warrants aggressive diagnostic evaluation.
Abstract:
The diagnosis of iliofemoral venous thrombosis prior to its progression to phlegmasia cerulea dolens can be difficult and, at times, confusing. The Doppler ultrasound examination in experienced hands can be extremely reliable and rapid in diagnosing the condition. During an 18 month period, we used the Doppler examination to diagnose iliofemoral venous thrombosis in 21 patients, 15 of whom had corroboration by venogram. The key to successful treatment and avoidance of significant complications was early and accurate diagnosis by the Doppler examination. No patient underwent operation or progressed to venous gangrene. Six were treated with streptokinase and the rest, with intravenous heparin, leg elevation, and stockings. We believe that iliofemoral venous thrombosis is a much more common disease than previously recognized and should be vigorously diagnosed and treated when a patient presents with a symptomatic extremity. The Doppler ultrasound examination represents a rapid, reliable alternative to the venogram in the early diagnosis of iliofemoral venous thrombosis.