Ultrasound Strategies for Suspected Lower-Extremity Deep Venous Thrombosis

What strategy is best for evaluating patients presenting with suspected deep venous thrombosis? Whole-leg color Doppler ultrasonography reveals more veins, including those in the calf, but requires specialized training and is frequently inaccessible, whereas 2-point compression ultrasonography is simple and widely available but requires a repeat test 1 week later to confirm normal results. Investigators randomized more than 2000 patients with suspected symptomatic DVT in 14 centers in Italy to either 2-point compression ultrasonography with provisional D-dimer testing or whole-leg color-coded Doppler ultrasonography and assessed the incidence of symptomatic venous thromboembolism (VTE) during the following 3 months.

Of the 1045 patients assi…