Detecting iliac vein thrombosis with current protocols of lower extremity venous duplex ultrasound

Ashish K. Jain, Michael C. Soult, Scott A Resnick, Kush R Desai, Patricia Astleford, Mark Eskandari, Heron Rodriguez Alvarez*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Deep venous thrombosis isolated to the iliac veins is uncommon. Venous duplex ultrasound (DU) is widely accepted as the screening modality of choice for lower extremity deep venous thromboses. This investigation evaluated the accuracy and efficacy of DU in diagnosis of iliac vein thrombosis. Methods: We conducted a single-center retrospective review of patients who were diagnosed with iliac vein thrombosis between January 1, 2006, and December 31, 2015. Patients included in our analysis needed to have both DU and cross-sectional imaging performed within a month of each other. The efficacy of DU in diagnosis of iliac vein thrombosis was determined using cross-sectional imaging as a standard for diagnosis. Results: In total, our query yielded 80 patients with a diagnosis of iliac vein thrombosis in the medical chart; 48 patients had both cross-sectional imaging and DU performed within 1 month of each other. There were 36 patients who had cross-sectional imaging positive for iliac vein thrombosis; only 10 (27.8%) of these patients were found to have iliac vein thrombosis by DU. Thus, 26 patients (72.2%) were not diagnosed accurately by DU. On the basis of our data, the sensitivity and positive predictive value of DU compared with cross-sectional imaging in diagnosis of iliac vein thrombosis were 27.8% and 76.9%, respectively. We did not identify any patient-specific factors that influenced the discrepancy between DU and cross-sectional imaging. Conclusions: Our current protocol of lower extremity venous DU is not an effective tool in diagnosis of iliac vein thrombosis. All patients with clinically suspected iliac vein thrombosis should be evaluated with specific pelvic ultrasound protocols or cross-sectional imaging.

Original languageEnglish (US)
Pages (from-to)724-729
Number of pages6
JournalJournal of Vascular Surgery: Venous and Lymphatic Disorders
Volume6
Issue number6
DOIs
StatePublished - Nov 1 2018

Fingerprint

Iliac Vein
Lower Extremity
Thrombosis
Venous Thrombosis
Ultrasonography

Keywords

  • Diagnosis
  • Iliac vein
  • Thrombosis
  • Veins
  • Venous thrombosis

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

@article{81fda88b89274767b03c8950ae3dfa91,
title = "Detecting iliac vein thrombosis with current protocols of lower extremity venous duplex ultrasound",
abstract = "Background: Deep venous thrombosis isolated to the iliac veins is uncommon. Venous duplex ultrasound (DU) is widely accepted as the screening modality of choice for lower extremity deep venous thromboses. This investigation evaluated the accuracy and efficacy of DU in diagnosis of iliac vein thrombosis. Methods: We conducted a single-center retrospective review of patients who were diagnosed with iliac vein thrombosis between January 1, 2006, and December 31, 2015. Patients included in our analysis needed to have both DU and cross-sectional imaging performed within a month of each other. The efficacy of DU in diagnosis of iliac vein thrombosis was determined using cross-sectional imaging as a standard for diagnosis. Results: In total, our query yielded 80 patients with a diagnosis of iliac vein thrombosis in the medical chart; 48 patients had both cross-sectional imaging and DU performed within 1 month of each other. There were 36 patients who had cross-sectional imaging positive for iliac vein thrombosis; only 10 (27.8{\%}) of these patients were found to have iliac vein thrombosis by DU. Thus, 26 patients (72.2{\%}) were not diagnosed accurately by DU. On the basis of our data, the sensitivity and positive predictive value of DU compared with cross-sectional imaging in diagnosis of iliac vein thrombosis were 27.8{\%} and 76.9{\%}, respectively. We did not identify any patient-specific factors that influenced the discrepancy between DU and cross-sectional imaging. Conclusions: Our current protocol of lower extremity venous DU is not an effective tool in diagnosis of iliac vein thrombosis. All patients with clinically suspected iliac vein thrombosis should be evaluated with specific pelvic ultrasound protocols or cross-sectional imaging.",
keywords = "Diagnosis, Iliac vein, Thrombosis, Veins, Venous thrombosis",
author = "Jain, {Ashish K.} and Soult, {Michael C.} and Resnick, {Scott A} and Desai, {Kush R} and Patricia Astleford and Mark Eskandari and {Rodriguez Alvarez}, Heron",
year = "2018",
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Detecting iliac vein thrombosis with current protocols of lower extremity venous duplex ultrasound. / Jain, Ashish K.; Soult, Michael C.; Resnick, Scott A; Desai, Kush R; Astleford, Patricia; Eskandari, Mark; Rodriguez Alvarez, Heron.

In: Journal of Vascular Surgery: Venous and Lymphatic Disorders, Vol. 6, No. 6, 01.11.2018, p. 724-729.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Detecting iliac vein thrombosis with current protocols of lower extremity venous duplex ultrasound

AU - Jain, Ashish K.

AU - Soult, Michael C.

AU - Resnick, Scott A

AU - Desai, Kush R

AU - Astleford, Patricia

AU - Eskandari, Mark

AU - Rodriguez Alvarez, Heron

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: Deep venous thrombosis isolated to the iliac veins is uncommon. Venous duplex ultrasound (DU) is widely accepted as the screening modality of choice for lower extremity deep venous thromboses. This investigation evaluated the accuracy and efficacy of DU in diagnosis of iliac vein thrombosis. Methods: We conducted a single-center retrospective review of patients who were diagnosed with iliac vein thrombosis between January 1, 2006, and December 31, 2015. Patients included in our analysis needed to have both DU and cross-sectional imaging performed within a month of each other. The efficacy of DU in diagnosis of iliac vein thrombosis was determined using cross-sectional imaging as a standard for diagnosis. Results: In total, our query yielded 80 patients with a diagnosis of iliac vein thrombosis in the medical chart; 48 patients had both cross-sectional imaging and DU performed within 1 month of each other. There were 36 patients who had cross-sectional imaging positive for iliac vein thrombosis; only 10 (27.8%) of these patients were found to have iliac vein thrombosis by DU. Thus, 26 patients (72.2%) were not diagnosed accurately by DU. On the basis of our data, the sensitivity and positive predictive value of DU compared with cross-sectional imaging in diagnosis of iliac vein thrombosis were 27.8% and 76.9%, respectively. We did not identify any patient-specific factors that influenced the discrepancy between DU and cross-sectional imaging. Conclusions: Our current protocol of lower extremity venous DU is not an effective tool in diagnosis of iliac vein thrombosis. All patients with clinically suspected iliac vein thrombosis should be evaluated with specific pelvic ultrasound protocols or cross-sectional imaging.

AB - Background: Deep venous thrombosis isolated to the iliac veins is uncommon. Venous duplex ultrasound (DU) is widely accepted as the screening modality of choice for lower extremity deep venous thromboses. This investigation evaluated the accuracy and efficacy of DU in diagnosis of iliac vein thrombosis. Methods: We conducted a single-center retrospective review of patients who were diagnosed with iliac vein thrombosis between January 1, 2006, and December 31, 2015. Patients included in our analysis needed to have both DU and cross-sectional imaging performed within a month of each other. The efficacy of DU in diagnosis of iliac vein thrombosis was determined using cross-sectional imaging as a standard for diagnosis. Results: In total, our query yielded 80 patients with a diagnosis of iliac vein thrombosis in the medical chart; 48 patients had both cross-sectional imaging and DU performed within 1 month of each other. There were 36 patients who had cross-sectional imaging positive for iliac vein thrombosis; only 10 (27.8%) of these patients were found to have iliac vein thrombosis by DU. Thus, 26 patients (72.2%) were not diagnosed accurately by DU. On the basis of our data, the sensitivity and positive predictive value of DU compared with cross-sectional imaging in diagnosis of iliac vein thrombosis were 27.8% and 76.9%, respectively. We did not identify any patient-specific factors that influenced the discrepancy between DU and cross-sectional imaging. Conclusions: Our current protocol of lower extremity venous DU is not an effective tool in diagnosis of iliac vein thrombosis. All patients with clinically suspected iliac vein thrombosis should be evaluated with specific pelvic ultrasound protocols or cross-sectional imaging.

KW - Diagnosis

KW - Iliac vein

KW - Thrombosis

KW - Veins

KW - Venous thrombosis

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