Normalization rates of compression ultrasonography in patients with a first episode of deep vein thrombosis of the lower limbs: association with recurrence and new thrombosis

• Published in: Haematologica (Roma) Vol. 87; no. 5; pp. 515 - 522
• Main Authors: Piovella, F, Crippa, L, Barone, M, Vigano D'Angelo, S, Serafini, S, Galli, L, Beltrametti, C, D'Angelo, A
• Format: Journal Article
• Language: English
• Published: Italy 01.05.2002
• Subjects: Adolescent; Aged; Aged, 80 and over; Female; Humans; Lower Extremity - blood supply; Lower Extremity - diagnostic imaging; Lower Extremity - pathology; Male; Methods; Middle Aged; Predictive Value of Tests; Prognosis; Prospective Studies; Recurrence; Risk Factors; Ultrasonography - methods; Venous Thrombosis - diagnosis; Venous Thrombosis - diagnostic imaging
• ISSN: 0390-6078; 1592-8721

Servizio Malattie Tromboemboliche, IRCCS Policlinico San Matteo, Pavia, Italy. BACKGROUND AND OBJECTIVES: Delayed thrombus regression after a first episode of deep vein thrombosis (DVT) of the inferior limbs has been implicated in the development of the post-thrombotic syndrome. Whether normalization of vein segments involved in the index DVT has prognostic significance with respect to the probability of DVT recurrence or new thrombosis is currently unknown. In this study, we prospectively monitored thrombus regression in consecutive patients with symptomatic and asymptomatic DVT. Factors affecting normalization rates and the relationship between previous normalization and DVT recurrence or new thrombosis were explored. DESIGN AND METHODS: One hundred and seventy-nine patients with a first episode of symptomatic DVT of the lower limbs (38 with cancer) and 104 patients with DVT occurring after hip replacement surgery were serially monitored by real time B-mode compression ultrasonography (C-US) over a period of 12 months (months 1, 3, 6 and 12). C-US normalization of popliteal and femoral venous segments was arbitrarily assigned to be residual thrombus occupying, at maximum compressibility, less than 40% of the vein area in the absence of compression. RESULTS: In patients with no DVT recurrence or new thrombosis, C-US normalization was observed at 12 months in 100% of 99 patients with post-operative DVT, in 59% of 134 cancer-free symptomatic DVT outpatients and in 23.3% of 30 symptomatic DVT outpatients with cancer (p = 0.0001). Independent negative effects on the probability of C-US normalization were observed for younger age (p