The diagnostic management of recurrent deep vein thrombosis and pulmonary embolism.
The diagnostic management of recurrent venous thromboembolism (VTE) is a clinical dilemma. Clinical decision rules are well validated in patients with a first episode of clinically suspected VTE but are not validated in patients with a suspected recurrent event. D-dimer testing could safely exclude a recurrent VTE but is subject to several limitations. Imaging could objectively exclude or establish the diagnosis of recurrent VTE, but due to persistent residual abnormalities after the first or previous event, imaging interpretation can be difficult. To limit the presence of uncertain imaging test results, a standardized baseline examination after anticoagulation cessation should be considered. This review will elaborate on these issues and will discuss the recent advancements in this area.
Department of Thrombosis and Haemostasis, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands. m.tan@lumc.nl
Melanie
M
Tan
Gerben
G
Mol
Jan
J
Kees van Rooden
Menno V
MV
Huisman
D000925:Anticoagulants / Q000627:therapeutic use; D003661:Decision Support Techniques; D003952:Diagnostic Imaging / Q000379:methods*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000188:drug therapy; D012008:Recurrence; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000188:drug therapy
D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D