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Abstract
Background. Because duplex ultrasonography is used increasingly to evaluate patients suspected
of having acute deep venous thrombosis of the lower extremity, the clinical significance
of limiting venous duplex scanning to the common femoral, superficial femoral, and
popliteal veins becomes an important question.
Methods. We prospectively studied by venous color flow duplex ultrasonography 181 patients
referred for evaluation to rule out acute deep venous thrombosis to determine (1)
the frequency with which the iliac and calf veins could be imaged adequately to determine
the presence or absence of acute deep venous thrombosis, (2) the frequency of acute
venous thrombosis in these venous segments, and (3) the time required to scan these
additional segments.
Results. In 79% of the patients studied, one segment of the iliac venous system was imaged
adequately to determine the presence or absence of venous thrombosis. In the lower
extremity, the common femoral vein, the superficial femoral vein, and the popliteal
vein were imaged adequately in 94% of the patients. In 76% of the patients all three
calf veins were imaged adequately to determine whether acute deep venous thrombosis
was present or absent. The anterior tibial vein was the most difficult vein to image
consistently and was imaged adequately in 76% of the patients referred. The mean time
to scan the affected limb was 8 minutes 37 seconds. Forty-seven patients (26%) of
the 180 patients studied had positive venous scans. Twenty-three percent of the patients
who had positive scans were found to have iliac vein involvement. Thirty-two percent
who had positive venous scans were found to have thrombosis of the calf veins. Fifteen
percent of the 47 patients who had positive scans had either an isolated iliac or
calf vein thrombosis.
Conclusions. We believe this frequency of isolated iliac or calf vein thrombosis coupled with
the frequency of successful imaging of these venous segments and the short additional
time required to image these segments justifies the inclusion of routine imaging of
the iliac and calf veins in patients undergoing venous duplex scanning to rule out
acute deep venous thrombosis.
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Article info
Publication history
Accepted:
August 17,
1992
Identification
Copyright
© 1993 Published by Elsevier Inc.
