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Venous thromboembolism: detection by duplex scanning
S C Nicholls1, J K O'Brian, M G Sutton
1Department of Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle 98104, USA.
Journal of Vascular Surgery
|March 1, 1996
Summary
Transcranial Doppler monitoring can detect venous embolism in patients with deep venous thrombosis. Heparin effectively reduced or abolished microemboli, but the link to pulmonary embolism requires further study.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Thrombosis Research
Background:
- Transcranial Doppler (TCD) is established for arterial embolism detection.
- Venous embolism detection using TCD is less explored.
- Anticoagulation's effect on venous embolism requires investigation.
Purpose of the Study:
- To extend TCD monitoring for venous embolism detection.
- To assess changes in embolism rate with anticoagulation therapy.
Main Methods:
- 218 patients with suspected deep venous thrombosis (DVT) underwent duplex scanning.
- Embolism detection and characterization were performed.
- Changes in embolism rates were monitored in patients receiving heparin.
Main Results:
- 26 out of 60 patients (43%) with positive DVT scans showed embolism.
- Embolus size ranged from 200 to 5000 micrometers.
- Heparin treatment led to a ≥50% decrease in embolus counts within 24 hours, with complete abolition within 72 hours.
Conclusions:
- Positive DVT scans correlate with a high incidence of ongoing embolism.
- Heparin demonstrated efficacy in eliminating detected microemboli.
- The clinical significance of microembolism in relation to DVT and pulmonary embolism needs further research.