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Review
. 2021 Aug 30;10(17):3903.
doi: 10.3390/jcm10173903.

The Use of Point-of-Care Ultrasound (POCUS) in the Diagnosis of Deep Vein Thrombosis

Dimitrios Varrias  1   2 , Leonidas Palaiodimos  1   2 , Prasanth Balasubramanian  1   2 , Christian A Barrera  1   2 , Peter Nauka  2   3 , Angelos Arfaras Melainis  1   2 , Christian Zamora  1   2 , Phaedon Zavras  1   2 , Marzio Napolitano  1   2 , Perminder Gulani  1   2 , George Ntaios  4 , Robert T Faillace  1   2 , Benjamin Galen  2   3
Affiliations
Review

The Use of Point-of-Care Ultrasound (POCUS) in the Diagnosis of Deep Vein Thrombosis

Dimitrios Varrias et al. J Clin Med. .

Abstract

Acute lower extremity proximal deep venous thrombosis (DVT) requires accurate diagnosis and treatment in order to prevent embolization and other complications. Point-of-care ultrasound (POCUS), a clinician performed, and clinician interpreted bedside ultrasound examination has been increasingly used for DVT evaluation mainly in the urgent and critical care setting, but also in the ambulatory clinics and the medical wards. Studies have demonstrated that POCUS has excellent diagnostic accuracy for acute proximal DVT when performed by well-trained users. However, there is significant heterogeneity among studies on the necessary extent of training and universally acceptable standardized education protocols are needed. In this review, we summarize the evidence that supports the use of POCUS to diagnose acute proximal DVT and focus on methodology and current technology, sensitivity and specificity, pre-test probability and the role of D-dimer, time and resources, education, limitations, and future directions.

Keywords: DVT; POCUS; VTE; deep vein thrombosis; point-of-care ultrasound; sonography; ultrasound; venous thromboembolism.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The three types of transducers used in point-of-care ultrasound (POCUS). The linear transducer (light green) is preferred for the evaluation of veins. DVT = deep vein thrombosis.
Figure 2
Figure 2
3-point POCUS technique for evaluation of acute proximal DVT in the right lower extremity. The “frog-leg” position is depicted. Veins were presented in all points before compression application. Abbreviations: Rt = right, CFV = common femoral vein, GSV = great saphenous vein, FV = femoral vein, DFV = deep femoral vein.
Figure 3
Figure 3
Cross-sectional anatomy of lower extremity proximal vasculature. Compressions should be performed at each of the marked points (3-point technique).
Figure 4
Figure 4
Echogenic thrombus is visible in the right popliteal vein (vein on the top of the artery).
Figure 5
Figure 5
Echogenic thrombus is visible in the left distal femoral vein (artery on the top of the vein).
See this image and copyright information in PMC

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