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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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Outcomes of isolated distal thrombosis managed with serial compression ultrasonography

Alexandra C Brewster1, Aubrey E Jones2, Stacy A Johnson2

  • 1University of Utah College of Pharmacy, 30 2000 E, Salt Lake City, UT 84112, United States.

Thrombosis Research
|October 30, 2021
PubMed

Insights

Serial compression ultrasonography (CUS) monitoring for isolated distal deep vein thrombosis (IDDVT) showed that most patients did not experience thrombus extension or need anticoagulation within 30 days. A history of venous thromboembolism (VTE) may predict adverse outcomes.

Area of Science:

  • Vascular Medicine
  • Thrombosis Research
  • Diagnostic Imaging

Background:

  • Isolated distal deep vein thrombosis (IDDVT) management lacks consensus, with differing recommendations for anticoagulation versus serial compression ultrasonography (CUS) monitoring.
  • Conflicting guidelines create uncertainty in managing IDDVT, particularly for patients not deemed high risk for proximal extension.

Purpose of the Study:

  • To evaluate outcomes of IDDVT managed with serial CUS monitoring.
  • To identify risk factors associated with proximal thrombus extension or the need for anticoagulant therapy initiation.

Main Methods:

  • Retrospective descriptive study utilizing electronic health data.
  • Inclusion of adult subjects with confirmed IDDVT managed via serial CUS monitoring.
  • 30-day follow-up for composite outcome: proximal extension or anticoagulant initiation.

Main Results:

  • 182 subjects included; 29.1% experienced the composite outcome (proximal extension or anticoagulation).
  • Of those with adverse outcomes, 22.6% had proximal extension, and 77.4% initiated anticoagulation.
  • A history of venous thromboembolism (VTE) was significantly more prevalent in subjects with the composite outcome.

Conclusions:

  • Approximately 70% of IDDVT patients managed with serial CUS monitoring avoided thrombus extension or anticoagulation within 30 days.
  • Serial CUS monitoring appears to be a viable management strategy for IDDVT.
  • Prior VTE history may indicate patients at higher risk for IDDVT progression or need for anticoagulation.
Abstract

Keywords:
AnticoagulantsIsolated distal deep vein thrombosisRetrospective studiesUltrasonographyVenous thrombosis

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