The use of indium-111 labeled platelet scanning for the detection of asymptomatic deep venous thrombosis in a high risk population.
Five hundred indium-111 labeled platelet imaging studies (387 donor and 113 autologous) were performed postoperatively in 473 patients who had undergone total hip replacement, total knee replacement, or internal fixation of a hip fracture to detect occult deep venous thrombosis. All patients had been anticoagulated prophylactically with aspirin, warfarin sodium (Coumadin), or dextran. Thirty-four possible cases of proximal deep venous thrombosis were identified in 28 asymptomatic patients. To verify the scan results, 31 venograms were performed in 25 patients (three refused). In 21 of 31 cases, totally occlusive thrombi were detected; in 5 cases, partially occlusive thrombi were detected; in 5 cases, no thrombus was seen. No patient who had a negative scan nor any patient who had a verified positive scan (and received appropriate heparin therapy) subsequently developed symptoms or signs of pulmonary embolism. One hundred forty-one indium study patients also underwent Doppler ultrasonography/impedance plethysmography (Doppler/IPG) as a comparative non-invasive technique. In 137 cases, the results of the indium study and Doppler/IPG studies were congruent. The indium study had no false negative results that were detected by Doppler/IPG. No patient had any clinically evident toxicity. These results suggest that indium-111 labeled platelet scanning is a safe, noninvasive means for identifying DVT in high risk patients.
Siegel
R S
RS
Department of Medicine, George Washington University Medical Center, Washington, DC.
Rae
J L
JL
Ryan
N L
NL
Edwards
C
C
Fortune
W P
WP
Lewis
R J
RJ
Reba
R C
RC
D000328:Adult; D001804:Blood Transfusion, Autologous; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D007595:Joint Prosthesis; D008297:Male; D010690:Phlebography; D017713:Platelet Transfusion; D010992:Plethysmography, Impedance; D011183:Postoperative Complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013924:Thrombophlebitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography
D007205:Indium Radioisotopes