Can the US examination for lower extremity deep venous thrombosis be abbreviated? A prospective study of 755 examinations.

PURPOSE: To determine if the ultrasound (US) survey of the lower extremity for deep venous thrombosis (DVT) can be curtailed without compromising diagnostic efficacy.

MATERIALS AND METHODS: The authors performed 755 US examinations in 721 patients (1,024 lower extremities) referred for suspicion of lower extremity DVT. The full lengths of the deep veins were studied, and findings were categorized at five locations: common femoral vein (CFV), proximal superficial femoral vein (CFV), mid-SFV, distal SFV, and popliteal vein (PV).

RESULTS: Acute thrombus was seen in one or more veins in 131 (17.4%) of the 755 examinations. DVT isolated to a single vein was seen in 28 (21.4%) of the 131 positive examinations: DVT was limited to the CFV in eight studies (61%), to the SFV in six studies (4.6%), and to the PV in 14 studies (10.7%).

CONCLUSIONS: DVT limited to a single vein occurs with sufficient frequency that the US screening survey cannot be abbreviated without loss of diagnostic efficacy.