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Semin Respir Crit Care Med 2012; 33(02): 151-155
DOI: 10.1055/s-0032-1311798
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Diagnostic Management of Recurrent Deep Vein Thrombosis and Pulmonary Embolism

Melanie Tan
1   Department of Thrombosis and Haemostasis, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
,
Gerben Mol
2   Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands.
,
Jan Kees van Rooden
3   Department of Radiology, Haga Teaching Hospital, The Hague, The Netherlands.
,
Menno V. Huisman
1   Department of Thrombosis and Haemostasis, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
› Author Affiliations
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Publication History

Publication Date:
30 May 2012 (online)

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Abstract

The diagnostic management of recurrent venous thromboembolism (VTE) is a clinical dilemma. Clinical decision rules are well validated in patients with a first episode of clinically suspected VTE but are not validated in patients with a suspected recurrent event. D-dimer testing could safely exclude a recurrent VTE but is subject to several limitations. Imaging could objectively exclude or establish the diagnosis of recurrent VTE, but due to persistent residual abnormalities after the first or previous event, imaging interpretation can be difficult. To limit the presence of uncertain imaging test results, a standardized baseline examination after anticoagulation cessation should be considered. This review will elaborate on these issues and will discuss the recent advancements in this area.

Keywords

diagnosis - venous thromboembolism - recurrent
 

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