Deep Venous Thrombosis and Whole-Leg vs. Proximal Compression Ultrasound

Risk for thromboembolism is low, but not zero, after a single negative whole-leg test.

Because distal deep venous thrombosis (DVT) can be missed when compression ultrasound (CUS) is limited to the proximal leg, a negative proximal study sometimes prompts a second CUS a few days later to exclude DVT that is propagating proximally from the calf. An alternate approach used by many vascular labs is to perform whole-leg CUS initially to detect distal DVT.

This alternate approach was evaluated in a meta-analysis of seven prospective cohort or randomized clinical trials that involved 4731 patients who had negative whole-leg CUS results and did not receive anticoagulation. During follow-up of at least 3 months, confirmed or presumed venous thromboembolic events occurred in 34 patients (0.7%); 9 of them died — all had been hospitalized…

Reviewing Author

Thomas L. Schwenk, MD

Disclosures

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Thomas L. Schwenk, MD

Disclosures

Editorial BoardsUpToDate