Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492013000200005
Jornal Vascular Brasileiro
Original Article

Correlation of clinical features with the risk of lower limb deep vein thrombosis assessed by duplex ultrasound

Liz Andrea Villela Baroncini; Graciliano Jose Franca; Aguinaldo de Oliveira; Enrique AntonioVidal; Carlos Eduardo Del Valle; Paulo Sergio Dalla Bona Stahlke; Paulo Henrique Stahlke; Rafael Faucz

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Abstract

BACKGROUND: Symptoms and clinical signs suggestive of deep vein thrombosis (DVT) are common but may have numerous possible causes. OBJECTIVES: 1) To identify the most frequent clinical symptoms and correlate them with duplex ultrasound scan (DS) findings; 2) to identify high-risk clinical conditions for DVT; and 3) to evaluate time since the onset of symptoms and DS examination. METHODS: A total of 528 patients with a clinical suspicion of DVT were evaluated by DS performed by experienced vascular ultrasonographists. RESULTS: DVT was present in 192 (36.4%) of the patients. The external iliac vein was involved in 53 patients (10.04%), the femoral veins in 110 (20.83%), the popliteal vein in 124 (23.48%), and veins below the knee were involved in 157 (29.73%) of the cases. Limb swelling was present in 359 cases (68%), and 303 (57.4%) complained of pain. Sixty nine patients received a DS due to suspected or proven pulmonary embolism (PE); 79 patients were in postoperative period. In the multivariate analysis, independent risk factors for DVT included age>65 years (OR=1.49; 95% confidence interval [95%CI] 1.01-2.18; p=0.042), edema (OR=2.83; 95%CI 1.72-4.65; p<0.001), pain (OR=1.99; 95%CI 1.3-3.05; p=0.002), cancer (OR=2.32; 95%CI 1.45-3.72; p<0.001), and PE (OR=2.62; 95%CI 1.29-5.32; p=0.008).Time since the onset of symptoms did not differ between the groups. CONCLUSIONS: In the present study, 36.4% of the patients referred to DS had DVT. Age > 65 years, presence of limb swelling, pain, cancer, and suspected or proven PE should be considered as major risk factors for DVT.

Keywords

deep venous thrombosis, ultrasonography, edema

References

Kahn SR. The clinicaldiagnosis of deepvenousthrombosis. ArchIntern Med.. ;158:2315-323.

López JA, Kearon C, Lee AYY. Deepvenousthrombosis. Hematology.. :439-56.

Maffei FHA, Caiafa JS, Ramacciotti E, Castro AA. Normas de orientação clínica para prevenção, o diagnóstico e o tratamento da trombose venosa profunda. J Vasc Bras.. ;4(Supl.3):S205-S220.

Bates SM, Jaeschke R, Stevens SM. Diagnosis of DVT. Antithrombotictherapyandprevention of thrombosis, 9th ed: American College of ChestPhysicians. Evidencebasedclinicalpracticeguidelines. Chest. ;141(2^sSuppl):e351S-e418S.

Fraser DGW, Moody AR, Morgan PS, Martel AL, Davidson I. Diagnosis of lower-limbdeepvenousthrombosis: a prospectiveblindedstudy of magneticresonancedirectthrombusimaging. Ann Intern Med.. ;36:89-98.

Barros MVL, Pereira VSR, Pinto DM. Controversies in thediagnosisandtreatment of deepveinthrombosis for vascular ultrasound. J Vasc Bras.. ;11:137-43.

Pini M, Marchini L, Giordano A. Diagnosticstrategies in venousthromboembolism. Haematologica.. ;84:535-40.

Giannini M, Rollo HA, Maffei FHA. Role of duplex scanning in thediagnosis of asymptomaticlower-extremitydeepvenousthrombosis. J Vasc Br.. ;4(3):290-96.

Mantoni M, Larsen L, Lund JO. Evaluation of chronicvenousdisease in thelowerlimbs: comparison of fivediagnosticmethods. British J Radiol. ;75:578-83.

Marik PE, Andrews L, Maini B. The incidence of deepvenousthrombosis in ICU patients. Chest.. ;111:661-64.

Döffler-Melly J. Diagnosticstrategies in deepvenousthrombosis. Kardiovasculäre Med.. ;9:110-15.

Kan KK, Koh WP, Chao AKH. Riskfactorsandpresentation of deepvenousthrombosisamongasianpatients a hospital-based-case-controlstudy in Singapore. Ann VascSurg.. ;21:490-95.

Fowkes FJI, Price JF, Fowkes FGR. Incidence of diagnoseddeepvenousthrombosis in the general population: systematicreview. Eur J VascEndovascSurg.. ;25:1-5.

Usech JN, Castro AMF, Galvis GE, Mantilla RA, Ariza A. Use of US in theevaluation of patientswithsymptoms of deepvenousthrombosis of thelowerextremities. Radiographics.. ;28:1785-797.

Oliveira A, França GJ, Vidal EA, Stalke PSDB, Baroncini LAV. Duplex scan in patientswithclinicalsuspicion of deepvenousthrombosis. CardiovascUltrasound.. ;6:53-3.

Ely JW, Osheroff A, Chambliss L, Ebell MH. Approach toleg edema of unclearetiology. J AmBoardFam Med.. ;19:148-60.

Kirkova J, Oneschuk D, Hanson J. Deepveinthrombosis (DVT) in advancedcancerpatientswithlowerextremity edema referred for assessment. Am J HospPalliatCare.. ;22:145-49.

Perrier A. Noninvasivediagnosis of pulmonaryembolism. Haematologica.. ;82:328-31.

Huisman MV, Klok FA. Diagnostic management of clinicallysuspectedacutepulmonaryembolism. J ThrombHaemost.. ;7:312-17.

Schwartz T, Hingorani A, Ascher E. Pulmonary embolism without deep venous thrombosis.. .

Atri M, Herba MJ, Reinhold C. Accuracy of sonography in theevaluation of calfdeepveinthrombosis in bothpostoperativesurveillanceandsymptomaticpatients. AJR.. ;166:1361-367.

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