Objective Diagnosis Of Recurrent Deep Vein Thrombosis

R Barnes, D Turley, G Qureshi, M Fratkin
1981 VIIIth International Congress on Thrombosis and Haemostasis   unpublished
Recurrent deep vein thrarbosis must be differentiated from other causes of leg pain, swelling and inflammation, including chronic venous insufficiency or the postphlebitic stasis syndrome. Venous obstruction and/or valvular incompetence was evaluated by Dcppler ultrasound in 229 patients with recurrent leg symptoms following one or more prior episodes of clinical deep vein thrombosis. The diagnostic sensitivity and specificity of the Dcppler technique was 96% and 90%, respectively, in 259
more » ... ively, in 259 consecutive contrast phlebograms. In a subset of 65 patients with abnormal Dcppler examination, I-125 fibrinogen leg scans were performed prior to institution of anticoagulants in order to establish the diagnosis of recurrent active thrarbosis (positive scan) or inactive postphlebitic disease (negative sca.In the 229 symptomatic patients screened, the Dcppler examination was normal in 87 (38.0%). In 65 patients with abnormal deep veins receiving I-125 fibrinogen, leg scans were positive in 25 (38.5%), suggesting active thrarbosis which was treated by anticoagulants. The remaining 40 patients were treated for the postphlebitic syndrome with leg elevation and elastic support and none developed manife stations of venous thrarboerrbolism.This study suggests that many individuals (38%) with suspected recurrent deep vein thrarbosis have normal leg veins and that the majority (62%) of patients with proven venous abnormalities have inactive (postphlebitic) disease which does not require anti coagulation.
doi:10.1055/s-0038-1652466 fatcat:jmswao4khvgcnbs44kgdc2rk5q