Integrated Diagnostic Approach to Venous Thromboembolism

2001 ◽  
pp. 252-261
Keyword(s):  
Venous Thromboembolism ◽  
Diagnostic Approach

scholarly journals Current Challenges in Diagnosis of Venous Thromboembolism

2020 ◽  
Vol 9 (11) ◽  
pp. 3509
Author(s):  
Zachary Liederman ◽  
Noel Chan ◽  
Vinai Bhagirath
Keyword(s):  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Cost Effective ◽  
Diagnostic Approach ◽  
Medical Patients ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Risk Patients ◽  
Diagnostic Framework ◽  
Deep Vein

In patients with suspected venous thromboembolism, the goal is to accurately and rapidly identify those with and without thrombosis. Failure to diagnose venous thromboembolism (VTE) can lead to fatal pulmonary embolism (PE), and unnecessary anticoagulation can cause avoidable bleeding. The adoption of a structured approach to VTE diagnosis, that includes clinical prediction rules, D-dimer testing and non-invasive imaging modalities, has enabled rapid, cost-effective and accurate VTE diagnosis, but problems still persist. First, with increased reliance on imaging and widespread use of sensitive multidetector computed tomography (CT) scanners, there is a potential for overdiagnosis of VTE. Second, the optimal strategy for diagnosing recurrent leg deep venous thrombosis remains unclear as is that for venous thrombosis at unusual sites. Third, the conventional diagnostic approach is inefficient in that it is unable to exclude VTE in high-risk patients. In this review, we outline pragmatic approaches for the clinician faced with difficult VTE diagnostic cases. In addition to discussing the principles of the current diagnostic framework, we explore the diagnostic approach to recurrent VTE, isolated distal deep-vein thrombosis (DVT), pregnancy associated VTE, subsegmental PE, and VTE diagnosis in complex medical patients (including those with impaired renal function).

Plasma Measurement of D-Dimer as Diagnostic Aid in Suspected Venous Thromboembolism: An Overview

1994 ◽  
Vol 71 (01) ◽  
pp. 001-006 ◽  
Author(s):  
H Bounameaux ◽  
P de Moerloose ◽  
A Perrier ◽  
G Reber
Keyword(s):  
Venous Thromboembolism ◽  
Clinical Decision Making ◽  
Plasma Concentrations ◽  
Clinical Decision ◽  
Elisa Test ◽  
Diagnostic Approach ◽  
Plasma Measurement ◽  
Patients At Risk ◽  
Elisa Technique ◽  
D Dimer

SummaryThis paper reviews the published experience with plasma measurement of D-dimer (DD), a specific degradation product of crosslinked fibrin, in the diagnostic approach of venous thromboembolism (VTE). Pooling 11 studies (with weighting of the figures according to sample size) with a total of 1337 patients clinically suspected of deep venous thrombosis (DVT) (prevalence of DVT 35%) disclosed an average weighted sensitivity of 96.8% (95% CI: 95.2–98.4) and specificity of 35.2% (95% Cl: 32.0–38.4) for the presence of DVT when the ELISA technique was used. In 908 patients suspected of pulmonary embolism (PE) from 9 trials (prevalence of PE 38%), the ELISA technique was associated with a weighted sensitivity of 96.8% (95% Cl: 95.0–98.6) and specificity of 45.1% (95% Cl: 40.8–49.4) for the disease. Figures obtained with latex assays were definitely lower, precluding their use in the diagnostic approach of VTE.These results show that a low concentration of plasma DD measured by the ELISA technique (usually less than 500 μg/1) might be used to rule out VTE in clinically suspected patients. Increased plasma concentrations are of no utility because of the low specificity of this test result.The clinical usefulness of the DD ELISA test should now be assessed in management trials under routine conditions, in the frame of clinical decision-making diagnostic processes. Lastly, the promising data obtained in a small number of asymptomatic, postoperative patients at risk of VTE deserve confirmation before the test can be recommended for initial screening in thrombo-prophylactic trials.

D-Dimer plasma concentration in various clinical conditions: Implication for the use of this test in the diagnostic approach of venous thromboembolism

1993 ◽  
Vol 69 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Pierre Raimondi ◽  
Olivier Bongard ◽  
Philippe de Moerloose ◽  
Guido Reber ◽  
Francis Waldvogel ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Plasma Concentration ◽  
Diagnostic Approach ◽  
Clinical Conditions ◽  
D Dimer

Validation of a diagnostic approach to exclude recurrent venous thromboembolism

2009 ◽  
Vol 7 (5) ◽  
pp. 752-759 ◽  
Author(s):  
G. LE GAL ◽  
M. J. KOVACS ◽  
M. CARRIER ◽  
K. DO ◽  
S. R. KAHN ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Diagnostic Approach ◽  
Recurrent Venous Thromboembolism

scholarly journals Venous thromboembolism — recommendations on the prevention, diagnostic approach and management. The 2017 Polish Consensus Statement

2017 ◽  
Vol 23 (2) ◽  
pp. 35-71 ◽  
Author(s):  
Witold Tomkowski ◽  
Paweł Kuca ◽  
Tomasz Urbanek ◽  
Dariusz Chmielewski ◽  
Zbigniew Krasiński ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Consensus Statement ◽  
Diagnostic Approach
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