Matthew Tabbut1, Nate Ebersole2, Lauren Icken3, Robert Jones1, Diane Gramer1. 1. MetroHealth Medical Center, Department of Emergency Medicine, Cleveland, Ohio. 2. MetroHealth Medical Center, Department of Medicine/Pediatrics, Cleveland, Ohio. 3. Albany Medical Center, Department of Emergency Medicine, Albany, New York.
Abstract
BACKGROUND: Deep vein thrombosis (DVT) is a common vascular problem seen in the emergency department (ED) and is commonly identified using ultrasound performed by a vascular lab, the radiology department, or at the point of care. Previous studies have assessed the utility of a two-point vs sequential technique to identify the presence of a thrombus. One particular study reported a concerning rate of isolated femoral vein thrombi that would be missed by a two-point technique. OBJECTIVES: In this study we sought to determine whether the two-point technique misses isolated femoral vein thrombi. METHODS: We conducted a retrospective review of patients who had a new diagnosis of DVT in the ED diagnosed with vascular lab, radiology, or point-of-care ultrasound to assess for the presence and rate of thrombi that would be missed using a two-point scanning technique. RESULTS: We included in our study 356 patients with a diagnosis of new DVT. In our population, 21 (5.9%; 0.95 confidence interval: 3.7%, 8.9%) patients were identified with thrombi isolated to the femoral vein. CONCLUSION: The two-point technique for lower extremity vascular ultrasound is insufficient for ruling out proximal DVTs in ED patients.
BACKGROUND: Deep vein thrombosis (DVT) is a common vascular problem seen in the emergency department (ED) and is commonly identified using ultrasound performed by a vascular lab, the radiology department, or at the point of care. Previous studies have assessed the utility of a two-point vs sequential technique to identify the presence of a thrombus. One particular study reported a concerning rate of isolated femoral vein thrombi that would be missed by a two-point technique. OBJECTIVES: In this study we sought to determine whether the two-point technique misses isolated femoral vein thrombi. METHODS: We conducted a retrospective review of patients who had a new diagnosis of DVT in the ED diagnosed with vascular lab, radiology, or point-of-care ultrasound to assess for the presence and rate of thrombi that would be missed using a two-point scanning technique. RESULTS: We included in our study 356 patients with a diagnosis of new DVT. In our population, 21 (5.9%; 0.95 confidence interval: 3.7%, 8.9%) patients were identified with thrombi isolated to the femoral vein. CONCLUSION: The two-point technique for lower extremity vascular ultrasound is insufficient for ruling out proximal DVTs in ED patients.
Authors: Jeffrey A Kline; Patrick M O'Malley; Vivek S Tayal; Gregory R Snead; Alice M Mitchell Journal: Ann Emerg Med Date: 2008-06-18 Impact factor: 5.721
Authors: Laurence Needleman; John J Cronan; Michael P Lilly; Geno J Merli; Srikar Adhikari; Barbara S Hertzberg; M Robert DeJong; Michael B Streiff; Mark H Meissner Journal: Circulation Date: 2018-04-03 Impact factor: 29.690