Deep venous thrombophlebitis following aortoiliac reconstructive surgery

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Thrombosis Research

Background:

• Deep venous thrombosis (DVT) is a potential complication following major vascular surgery.
• Accurate and timely diagnosis of DVT is crucial for patient management and preventing complications like pulmonary embolism.
• Existing diagnostic methods have limitations in terms of accuracy, invasiveness, and false-positive rates.

Purpose of the Study:

• To prospectively evaluate the incidence of DVT in patients undergoing elective aortic surgery.
• To compare the diagnostic accuracy of venous Doppler ultrasound and fibrinogen scanning against venography for DVT detection.
• To assess the clinical utility of these imaging modalities in this specific surgical population.

Main Methods:

• Prospective study of 100 patients undergoing elective aortic surgery.
• Venous Doppler ultrasound and fibrinogen scanning were performed.
• Venography served as the gold standard for DVT diagnosis.

Main Results:

• The incidence of DVT was 13% (13 out of 100 patients).
• Venous Doppler ultrasound showed 80% correlation with venography and correctly identified all cases of occlusive iliofemoral thrombus.
• Fibrinogen scanning exhibited a high false-positive rate of 31%.

Conclusions:

• Doppler ultrasound is a reliable method for detecting significant occlusive DVT after aortic surgery with a low false-positive rate.
• Fibrinogen scanning is not recommended due to its high false-positive rate in this patient group.
• The low incidence of pulmonary embolism in this study does not support prophylactic vena caval interruption.