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The diagnosis of acute, recurrent, deep-vein thrombosis: a diagnostic challenge.
Circulation. 1983 Apr; 67(4):901-6.Circ

Abstract

Recurrent venous thrombosis presents a diagnostic challenge. Venography, impedance plethysmography and fibrinogen leg scanning all have potential limitations, and their role in this context has not been evaluated. We performed a prospective cohort study evaluating impedance plethysmography and leg scanning, plus venography, using outcome on long-term follow-up as the end point in 270 patients with clinically suspected recurrent deep-vein thrombosis. Anticoagulant treatment was withheld in the 181 patients negative by noninvasive testing and was given in patients positive by impedance plethysmography if leg scanning was positive or if intraluminal filling defects were detected by venography. The validity of this approach was tested by long-term follow-up. Three of 181 patients (1.7%) negative by noninvasive testing had a recurrence, compared with 18 of 89 (20%) with positive findings (p less than 0.001). Our objective diagnostic approach has high clinical utility; an objective rationale for withholding or giving treatment was established in 95% of patients.

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Authors

Hull RD
No affiliation info available
Carter CJ
No affiliation info available
Jay RM
No affiliation info available
Ockelford PA
No affiliation info available
Hirsch J
No affiliation info available
Turpie AG
No affiliation info available
Zielinsky A
No affiliation info available
Gent M
No affiliation info available
Powers PJ
No affiliation info available

MeSH

Acute DiseaseAdolescentAdultAgedAnticoagulantsFemaleHumansLegMaleMiddle AgedPlethysmography, ImpedanceRadionuclide ImagingRecurrenceThromboembolismThrombophlebitis

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

6825247

Clinical Trial Links

Diagnosis Exclusion of Recurrent Deep Vein Thrombosis of the Lower Limbs

Citation

Hull, R D., et al. "The Diagnosis of Acute, Recurrent, Deep-vein Thrombosis: a Diagnostic Challenge." Circulation, vol. 67, no. 4, 1983, pp. 901-6.
Hull RD, Carter CJ, Jay RM, et al. The diagnosis of acute, recurrent, deep-vein thrombosis: a diagnostic challenge. Circulation. 1983;67(4):901-6.
Hull, R. D., Carter, C. J., Jay, R. M., Ockelford, P. A., Hirsch, J., Turpie, A. G., Zielinsky, A., Gent, M., & Powers, P. J. (1983). The diagnosis of acute, recurrent, deep-vein thrombosis: a diagnostic challenge. Circulation, 67(4), 901-6.
Hull RD, et al. The Diagnosis of Acute, Recurrent, Deep-vein Thrombosis: a Diagnostic Challenge. Circulation. 1983;67(4):901-6. PubMed PMID: 6825247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The diagnosis of acute, recurrent, deep-vein thrombosis: a diagnostic challenge. AU - Hull,R D, AU - Carter,C J, AU - Jay,R M, AU - Ockelford,P A, AU - Hirsch,J, AU - Turpie,A G, AU - Zielinsky,A, AU - Gent,M, AU - Powers,P J, PY - 1983/4/1/pubmed PY - 1983/4/1/medline PY - 1983/4/1/entrez SP - 901 EP - 6 JF - Circulation JO - Circulation VL - 67 IS - 4 N2 - Recurrent venous thrombosis presents a diagnostic challenge. Venography, impedance plethysmography and fibrinogen leg scanning all have potential limitations, and their role in this context has not been evaluated. We performed a prospective cohort study evaluating impedance plethysmography and leg scanning, plus venography, using outcome on long-term follow-up as the end point in 270 patients with clinically suspected recurrent deep-vein thrombosis. Anticoagulant treatment was withheld in the 181 patients negative by noninvasive testing and was given in patients positive by impedance plethysmography if leg scanning was positive or if intraluminal filling defects were detected by venography. The validity of this approach was tested by long-term follow-up. Three of 181 patients (1.7%) negative by noninvasive testing had a recurrence, compared with 18 of 89 (20%) with positive findings (p less than 0.001). Our objective diagnostic approach has high clinical utility; an objective rationale for withholding or giving treatment was established in 95% of patients. SN - 0009-7322 UR - https://www.unboundmedicine.com/medline/citation/6825247/The_diagnosis_of_acute_recurrent_deep_vein_thrombosis:_a_diagnostic_challenge_ L2 - https://www.ahajournals.org/doi/10.1161/01.cir.67.4.901?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -