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Plasma D-dimer changes and clinical value in acute lower extremity deep venous thrombosis treated with

Jixu Wang1, Yide Zheng2, Yongzhong Yu2

  • 1Department of Vascular Surgery, Chenzhou First People's Hospital and the First Affiliated Hospital of Xiangnan University, Chenzhou, Hunan Province, China; Department of Medical lmaging Laboratory and Rehabilitation, Xiangnan University, Chenzhou, Hunan Province, China; Department of Interventional Vascular Surgery, Affiliated Hospital (Clinical College) of Xiangnan University, Chenzhou, Hunan Province, China.

Journal of Vascular Surgery. Venous and Lymphatic Disorders
|January 16, 2025
PubMed

Insights

Plasma D-dimer levels can indicate the effectiveness of catheter-directed thrombolysis (CDT) for acute deep venous thrombosis (DVT). Monitoring D-dimer during CDT helps assess thrombus clearance and treatment success in lower extremity DVT patients.

Area of Science:

  • Vascular Medicine
  • Interventional Radiology
  • Hematology

Background:

  • Acute lower extremity deep venous thrombosis (DVT) poses significant risks.
  • Catheter-directed thrombolysis (CDT) is a treatment option for DVT.
  • Monitoring treatment efficacy is crucial for patient outcomes.

Purpose of the Study:

  • To investigate plasma D-dimer level changes during CDT for acute lower extremity DVT.
  • To analyze imaging results and clinical implications of D-dimer levels.
  • To assess the correlation between D-dimer levels and thrombus clearance.

Main Methods:

  • Retrospective analysis of 62 patients undergoing CDT for acute lower extremity DVT.
  • Serial measurement of plasma D-dimer levels before, during, and after CDT.
  • Regular lower limb venography to assess thrombus clearance rate and dissolution.
  • Statistical analysis including correlation and ROC curve construction to evaluate D-dimer's diagnostic performance.

Main Results:

  • Plasma D-dimer levels increased initially, then decreased during CDT, showing a strong positive correlation with thrombolysis efficacy (r=0.809).
  • The receiver operating characteristic curve demonstrated high diagnostic performance for D-dimer (AUC=0.95).
  • An optimal cut-off value of 9.935 mg/L for D-dimer indicated high sensitivity (93.2%) and specificity (95.4%) in assessing thrombolysis efficacy.

Conclusions:

  • Plasma D-dimer concentration is a reliable indicator for evaluating thrombolysis efficacy during CDT in acute lower extremity DVT.
  • D-dimer monitoring can aid in real-time assessment of treatment response.
  • This finding supports the use of D-dimer as a biomarker in managing DVT with CDT.
Abstract

Keywords:
Acute lower extremity deep venous thrombosisCatheter-directed thrombolysisPlasma D-dimerThrombus dissolution rate

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