Recent clinical trials in the diagnosis of deep-vein thrombosis.
Contrast venography remains the gold standard for the diagnosis of deep-vein thrombosis (DVT). However, an ongoing interest exists in developing safe diagnostic strategies that are less invasive, less expensive, widely and readily available, and more acceptable to patients than venography. For patients with symptoms suggestive of DVT, ultrasound is now the most frequently used test. Recent clinical outcome studies have evaluated management strategies that use ultrasound testing, either alone or with adjunct D-dimer testing or clinical risk stratification. Based on current evidence, a noninvasive strategy using compression ultrasound has been shown to be a safe alternative for patients suspected of having DVT, and an approach using D-dimer also appears promising. Neither ultrasound nor other noninvasive tests are adequately sensitive when used with patients who do not have leg symptoms but who are at high risk for DVT (eg, recent total knee or hip arthroplasty). Thus, no currently available noninvasive testing strategy can reliably exclude DVT in asymptomatic patients.
Birdwell
B
B
University of Oklahoma Health Sciences Center, General Internal Medicine, Oklahoma City, USA.
D002986:Clinical Trials as Topic; D006801:Humans; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*