Abstract
Introduction
Compression ultrasonography (CUS) is a validated technique for the diagnosis of deep
venous thrombosis (DVT), but has never been studied with pocket-sized ultrasound device
(PUD). The main objective of this study was to assess the diagnostic performance of
CUS made by emergency physicians (EPs) using a PUD.
Materials
This was a prospective, diagnostic test assessment, single-center study. Patients
underwent VCU performed by a trained EP with PUD (CUS-PUD) for searching proximal
DVT (PDVT) and were then seen by an expert vascular physician who blindly performed
a duplex venous ultrasound, which was the criterion standard. CUS-PUD's diagnostic
performance was evaluated by sensitivity (Se), specificity (Sp), and positive and
negative predictive values (PPV and NPV).
Results
The sample included 57 patients of whom 56 were analyzed. Eleven (20%) PDVT were diagnosed
with CUS-PUD: 7 (64%) femoral and 4 (36%) popliteal. The CUS-PUD's Se was 100% [72%;
100%], Sp 100% [92%; 100%]. The PPV was 100% [74%; 100%], and the NPV was 100% [90%;
100%].
Conclusion
CUS-PUD performed with a pocket-sized ultrasound appears to be feasible in emergency
practice for the diagnosis of proximal DVT. A study with a larger sample size will
have to describe the accuracy.
Keywords
To read this article in full you will need to make a payment
Subscribe to The American Journal of Emergency Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Emergency department compression ultrasound to diagnose proximal deep vein thrombosis.J Emerg Med. 2001 Feb; 20: 107-112
- A positive compression ultrasonography of the lower limb veins is highly predictive of pulmonary embolism on computed tomography in suspected patients.Thromb Haemost. 2006 Jun; 95: 963-966
- Accuracy of emergency physician-performed ultrasonography in the diagnosis of deep-vein thrombosis: a systematic review and meta-analysis.Thromb Haemost. 2013 Jan; 109: 137-145
- Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.Chest. 2012 Feb; 141e419S-94S
- Emergency, point-of-care and clinical ultrasound guidelines in medicine.Ann Emerg Med. 2017 May; 69: e27-e54
- Point-of-care ultrasonography.N Engl J Med. 2011 Feb 24; 364: 749-757
- Diagnosis of DVT: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.Chest. 2012 Feb; 141: e351S-e418S
- Detection of deep-vein thrombosis by real-time B-mode ultrasonography.N Engl J Med. 1989 Feb 9; 320: 342-345
- Comparison of the accuracy of emergency department-performed point-of-care-ultrasound (POCUS) in the diagnosis of lower-extremity deep vein thrombosis.J Emerg Med. 2018 Jan; 3
- Resident-performed compression ultrasonography for the detection of proximal deep vein thrombosis: fast and accurate.Acad Emerg Med. 2004 Mar; 11: 319-322
- Compression ultrasonography of the lower extremity with portable vascular ultrasonography can accurately detect deep venous thrombosis in the emergency department.Ann Emerg Med. 2010 Dec; 56: 601-610
- Point-of-care ultrasound in medical education—stop listening and look.N Engl J Med. 2014 Mar 20; 370: 1083-1085
- Evaluation of a new pocket echoscopic device for focused cardiac ultrasonography in an emergency setting.Crit Care. 2012; 16: R82
- Fast track echo of abdominal aortic aneurysm using a real pocket-ultrasound device at bedside.Echocardiography. 2012 Mar; 29: 285-290
- Does physician experience influence the interpretability of focused echocardiography images performed by a pocket device?.Scand J Trauma Resusc Emerg Med. 2015 Jul 7; 23: 52
- Duplex ultrasound in the emergency department for the diagnostic management of clinically suspected deep vein thrombosis.Acad Emerg Med. 2007 Mar; 14: 216-220
Article Info
Publication History
Published online: April 03, 2018
Accepted:
March 29,
2018
Received in revised form:
March 28,
2018
Received:
March 6,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
