Clinical and Laboratory Diagnosis of Deep Vein Thrombosis: New Cost-Effective Strategies

Henri Bounameaux; Arnaud Perrier; Philip S. Wells

doi:10.1055/s-2001-14540

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Semin Vasc Med 2001; 01(1): 039-042
DOI: 10.1055/s-2001-14540

Clinical and Laboratory Diagnosis of Deep Vein Thrombosis: New Cost-Effective Strategies

Henri Bounameaux¹ , Arnaud Perrier² , Philip S. Wells³

¹Division of Angiology and Hemostasis, Medical Clinic, University Hospital of Geneva, Geneva, Switzerland
²Department of Internal Medicine, Medical Clinic, University Hospital of Geneva, Geneva, Switzerland
³Division of Hematology, Ottawa Civic Hospital, Ottawa, Canada

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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

Diagnosis of deep vein thrombosis (DVT) has been made easier, less invasive, and somewhat safer over the past 2 decades. This has been due mainly to the development of venous compression ultrasonography (US). The prevalence of the disease in patients clinically suspected of DVT has steadily decreased during the past 10 years, likely as a consequence of the accurate noninvasive test, ultrasound imaging. This has led to the development of diagnostic tools that aim at reducing the number of unnecessary US exams. These include clinical probability assessment and fibrin D-dimer. Several strategies combining these tools have been validated in large-outcome studies and compared in a formal cost-effectiveness analysis. The results indicate that they should now be implemented in daily practice, taking into account local facilities and expertise.

KEYWORD

Deep vein thrombosis - venous compression ultrasonography - D-dimer

REFERENCES

1 Lensing A W, Prandoni P, Prins M H, Büller H R. Deep-vein thrombosis. Lancet . 1999; 353 479-485

Crossref PubMed Search in Google Scholar
2 Sandler D A, Duncan J S, Ward P. Diagnosis of deep-vein thrombosis: comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram. Lancet . 1984; 1 716-719

PubMed Search in Google Scholar
3 Wells P S, Anderson D R, Bormani J. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet . 1997; 350 1795-1798

Search in Google Scholar
4 Cogo A, Lensing A WA, Koopman M MW. Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study. BMJ . 1998; 316 17-20

Search in Google Scholar
5 Bernardi E, Prandoni P, Lensing A W. D-dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study. The Multicentre Italian D-dimer Ultrasound Study Investigators Group. BMJ . 1998; 317 1037-1040

Crossref PubMed Search in Google Scholar
6 Perrier A, Desmarais S, Miron M J. Non-invasive diagnosis of venous thromboembolism in outpatients. Lancet . 1999; 353 190-195

Search in Google Scholar
7 Miron M J, Perrier A, Bounameaux H. Clinical probability of deep vein thrombosis: comparison between a score and an empirical assessment. J Intern Med . 2000; 247 249-254

Crossref PubMed Search in Google Scholar
8 Bigaroni A, Perrier A, Bounameaux H. Is clinical probability assessment of deep vein thrombosis by a score really standardized?. Thromb Haemost . 2000; 83 788-789

PubMed Search in Google Scholar
9 Bounameaux H, de Moerloose P, Perrier A, Miron M J. D-dimer testing in suspected venous thromboembolism: an update. QJM . 1997; 90 437-442

Crossref PubMed Search in Google Scholar
10 Ginsberg J S, Kearon C, Douketis J. The use of D-dimer testing and impedance plethysmographic examination in patients with clinical indications of deep vein thrombosis. Arch Intern Med . 1997; 157 1077-1081

Crossref PubMed Search in Google Scholar
11 Wells P S, Anderson D R, Bormanis J, Guy F, Mitchell M, Lewandowski B. SimpliRED D-dimer can reduce the diagnostic tests in suspected deep vein thrombosis. Lancet . 1998; 351 1405-1406

Crossref PubMed Search in Google Scholar
12 Kearon C, Ginsberg J S, Hirsh J. The role of venous ultrasonography in the diagnosis of suspected deep venous thrombosis and pulmonary embolism. Ann Intern Med . 1998; 129 1044-1049

Search in Google Scholar
13 Kakkar V V, Flanc C, Howe C T, Clarke M B. Natural history of postoperative deep-vein thrombosis. Lancet . 1969; 2 230-232

Search in Google Scholar
14 Bounameaux H, Perrier A. Rapid diagnosis of deep vein thrombosis in symptomatic patients: a comparison between four different diagnostic strategies. Thromb Haemost . 1999; 82 1360-1361

PubMed Search in Google Scholar
15 Bounameaux H, Perrier A. Compression ultrasonography for diagnosing deep vein thrombosis. Repeat testing is unjustified. BMJ . 1998; 316 1534-1535

PubMed Search in Google Scholar
16 Rabinov K, Paulin S. Roentgen diagnosis of venous thrombosis in the leg. Arch Surg . 1972; 104 134-144

PubMed Search in Google Scholar
17 Bounameaux H, Perrier A. Rapid diagnosis of deep vein thrombosis: a comparison between four strategies. Thromb Haemost . 1999; 82 1360-1361

PubMed Search in Google Scholar
18 Hull R, Hirsh J, Sackett D L. Clinical validity of a negative venogram in patients with clinically suspected venous thrombosis. Circulation . 1981; 64 622-625

Crossref PubMed Search in Google Scholar
19 Perone N, Bounameaux H, Perrier A. Comparison of four strategies for diagnosing deep vein thrombosis: a cost-effectiveness analysis. Am J Med . 2001; 110 33-40

Search in Google Scholar