title: Aging techniques for deep vein thrombosis: a systematic review.
abstract: Deep vein thrombosis is common with an incidence of 1 in 1000. Acute thrombus removal for extensive proximal deep vein thrombosis using catheter-directed techniques highlights the need for accurate assessment of thrombus age. This systematic review summarises experimental and clinical evidence of imaging techniques for aging deep vein thrombosis. Ultrasound elastography and magnetic resonance imaging were highlighted as the most studied imaging modalities. Elastography was shown to distinguish between acute and chronic clots, despite demonstrating difficulty in accurate aging of clots older than 10 days in rat models. Elastography is noted as a feasible adjunct to current first-line imaging for deep vein thrombosis using duplex ultrasonography. Combinations of magnetic resonance imaging techniques can identify acute, sub-acute and chronic thrombi using endogenous contrast agents and provide objective standardisation of the diagnostic process, with reduced onus upon operator dependency. Further validation is required of these novel imaging techniques prior to clinical implementation for deep vein thrombosis aging.
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK Division of Experimental Medicine, Imperial College London, London, UK b.dharmarajah@imperial.ac.uk.
authors.forename: B
authors.initials: B
authors.lastname: Dharmarajah
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: V
authors.initials: V
authors.lastname: Sounderajah
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: S P
authors.initials: SP
authors.lastname: Rowland
authors.affiliation: Division of Experimental Medicine, Imperial College London, London, UK.
authors.forename: E L S
authors.initials: EL
authors.lastname: Leen
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: A H
authors.initials: AH
authors.lastname: Davies
mesh_terms: D000208:Acute Disease; D000818:Animals; D002908:Chronic Disease; D003287:Contrast Media / Q000627:therapeutic use*; D054459:Elasticity Imaging Techniques; D006801:Humans; D008279:Magnetic Resonance Imaging; D061185:Mechanical Thrombolysis; D011859:Radiography; D051381:Rats; D013997:Time Factors; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery
chemical_list: D003287:Contrast Media
keywords: Deep vein thrombosis; VTE management; duplex ultrasound; magnetic resonance imaging