A prospective follow-up study of acute deep venous thrombosis using colour duplex ultrasound, phlebography and venous occlusion plethysmography

Abstract

Objective: To study the extent of deep venous thrombosis (DVT) and thrombus regression over time and to compare the results obtained with different diagnostic techniques.

Experimental design: A prospective follow-up study with repeated examinations during a 6-month period.

Setting: Patients studied at clinical vascular laboratories.

Patients: Forty patients hospitalised for acute DVT. Thirty-six of these completed the follow-up period.

Measures: The diagnosis of DVT was confirmed with phlebographic and/or ultrasonographic techniques. The patient were then re-examined with colour duplex ultrasound and venous occlusion plethysmography after one week, 3 months and 6 months and with phlebography after 1 week and 6 months. The extent of DVT and number of occluded segments were determined with phlebographic and ultrasonographic techniques. Venous occlusion plethysmography was used to evaluate the functional degree of outflow obstruction.

Results: Colour duplex scanning at 3 months' and 6 months' follow-up showed that 55% and 74% of initially occlusive thrombi, respectively, were recanalized, with thrombus resolution occurring faster and more completely in those initially limited to popliteal and/or calf level. Discrepancies between phlebography and duplex scanning were found in 6% (26/441) of venous segments investigated by both methods, primarily concerning flow in the veins below the knee.

Conclusions: In comparison with phlebography, colour duplex scanning is an accurate method for evaluation and follow-up of patients with DVT. The non-invasive nature of colour duplex scanning makes this method extremely suitable for repeated studies and thus a potentially very valuable tool for both clinical and research studies of circulatory changes involved in acute and chronic DVT.