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Review
. 2019 Dec 13;23(2):111-120.
doi: 10.1002/ajum.12188. eCollection 2020 May.

Point-of-care ultrasound for deep venous thrombosis of the lower limb

David Canty  1   2   3   4 , Kavi Mufti  3   5 , Lindsay Bridgford  1   6 , André Denault  7   8
Affiliations
Review

Point-of-care ultrasound for deep venous thrombosis of the lower limb

David Canty et al. Australas J Ultrasound Med. .

Abstract

The incidence and morbidity of deep venous thrombosis (DVT) and pulmonary embolus are high. Although efforts to increase screening for DVT have been recommended, this is limited by resources. Venous duplex ultrasound has replaced venography as the first-line investigation of choice for DVT, increasing availability and reducing patient exposure to radiation and intravenous contrast. Furthermore, an abbreviated ultrasound where DVT is inferred from incomplete venous compressibility has an equivalent accuracy to venous duplex, requiring less time and training enabling its widespread use by emergency, critical care and anaesthesia clinicians. In this review, the evolution and method of lower limb venous compression ultrasound is described along with evidence for its use in patients at high risk for DVT in these clinical settings.

Keywords: compression venography; deep venous thrombosis; point‐of‐care ultrasound; screening; venous Doppler ultrasound.

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Conflict of interest statement

David Canty is an employee of the University of Melbourne. Educational content is available for sale in Australia.

Figures

Figure 1
Figure 1
Sonoanatomy of the lower extremity venous system.
Figure 2
Figure 2
Positioning of the lower limb for compression ultrasound examination. Knee 20–30° bend and hip 30° externally rotated (frog’s leg position) to allow full access to the medial part of the thigh and the popliteal fossa.
Figure 3
Figure 3
Compression point 1 – junction of common femoral vein and greater saphenous vein. CFA, common femoral artery; CFV, common femoral vein; GSV, greater saphenous vein.
Figure 4
Figure 4
Compression point 2 – femoral vein; FA, femoral artery; FV, femoral vein; ProfV, femoral profunda vein.
Figure 5
Figure 5
Compression point 3 – popliteal vein; PV, popliteal artery; PA.
Figure 6
Figure 6
Two‐hand technique used when obesity limits venous compression.
Figure 7
Figure 7
Femoral lymph node. LN, lymph node.
See this image and copyright information in PMC

References

    1. Næss IA, Christiansen S, Romundstad P, Cannegieter S, Rosendaal FR, Hammerstrøm J. Incidence and mortality of venous thrombosis: a population‐based study. J Thromb Haemost 2007; 5(4): 692–9. - PubMed
    1. Ho WK, Hankey GJ, Eikelboom JW. The incidence of venous thromboembolism: a prospective, community‐based study in Perth, Western Australia. Med J Australia 2008; 189(3): 144–7. - PubMed
    1. Weinmann EE, Salzman EW. Deep‐vein thrombosis. N Engl J Med 1994; 331(24): 1630–41. - PubMed
    1. Hirsh J, Hoak J. Management of deep vein thrombosis and pulmonary embolism: a statement for healthcare professionals from the council on thrombosis (in consultation with the council on cardiovascular radiology), American Heart Association. Circulation 1996; 93(12): 2212–45. - PubMed
    1. Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25‐year population‐based study. Arch Intern Med 1998; 158(6): 585–93. - PubMed