title: Venous lower-limb evaluation in patients with acute pulmonary embolism.
abstract: OBJECTIVE
  Compressive ultrasonography (CUS) of the lower limbs is the first choice for identifying deep venous thrombosis (DVT) in patients with symptomatic pulmonary embolism (PE). The aim of this study was to uncover clinical characteristics and CUS findings in patients with proven PE and their correlations with PE extent.
  
  
  METHODS
  A total of 524 consecutive cases of proven symptomatic PE diagnosed between January 1996 and December 2006 were reviewed.
  
  
  RESULTS
  Mean age was 71.06 ± 14.43 SD years; 244 patients (46.6%) were men. DVT signs or symptoms were present in 30.9% of patients and were associated with the femoral site (P = 0.029). CUS was performed in 383 patients (73.1%) and DVT was found in 75.5%. In 94.1% of patients DVT was proximal (popliteal and/or femoral), which would have been then identified by simplified CUS. CUS was performed significantly more often in presence of signs or symptoms of DVT (P < 0.001), less often in presence of medical illnesses (P = 0.040), age ≥75 years (P = 0.001) and death in hospital (P < 0.001). Signs or symptoms of DVT were predictors of positive CUS (P < 0.001), presence of medical illnesses (P = 0.020), central venous catheter (P = 0.035), death in hospital (P = 0.032) were predictors of negative CUS findings. Neither clinical findings nor CUS were associated with PE extent.
  
  
  CONCLUSIONS
  In patients with proven symptomatic PE, signs or symptoms of DVT are present only in 1/3 of cases and are significantly more frequent when DVT is extended to the femoral vein. Simplified CUS of the lower limbs has a high sensitivity in finding proximal DVT. CUS is not able to predict PE extent.
authors: Internal Medicine Department, Emergency Department, Santa Croce and Carle General Hospital, Cuneo, Italy.
authors: Fulvio
authors: F
authors: Pomero
authors: Chiara
authors: C
authors: Brignone
authors: Cristina
authors: C
authors: Serraino
authors: Sergio
authors: S
authors: Panzone
authors: Christian
authors: C
authors: Bracco
authors: Elena
authors: E
authors: Migliore
authors: Paola
authors: P
authors: Dalmasso
authors: Paolo Cavallo
authors: PC
authors: Perin
authors: Luigi Maria
authors: LM
authors: Fenoglio
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006801:Humans; D035002:Lower Extremity / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011152:Popliteal Vein / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D015995:Prevalence; D011655:Pulmonary Embolism / Q000150:complications*; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*