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A prospective blind study on diagnosis and clinical risk of isolated calf deep vein thrombosis in symptomatic outpatients (the calthro study; NCT00816920)
Abstract number: AS-TH-029
Palareti1 G., Cosmi1 B., Lessiani2 G., Rodorigo1 G., Guazzaloca1 G., Brusi1 C., Conti1 E., Filippini1 M., Sartori1 M., Legnani1 C.
11Angiology and Blood Coagulation, University Hospital S. Orsola-Malpighi, Bologna 22Fisiopatologia Vascolare, Casa di Cura Villa Serena, Pescara, Italy
How-to-cite Palareti G, Cosmi B, Lessiani G, Rodorigo G, Guazzaloca G, Brusi C, Conti E, Filippini M, Sartori M, Legnani C. A prospective blind study on diagnosis and clinical risk of isolated calf deep vein thrombosis in symptomatic outpatients (the calthro study; NCT00816920). Journal of Thrombosis and Haemostasis 2009; Volume 7, Supplement 2: Abstract AS-TH-029
Compression ultrasonography limited to proximal veins (PCUS), repeated after 5–7 days if pre-test clinical probability (PCP) is likely and/or D-dimer assay (Dd) altered, is a standard diagnostic strategy in outpatients symptomatic for leg DVT. Some authors however recommend to perform a single complete examination of leg veins (CCUS) to diagnose and treat isolated calf DVT (ICDVT). However, no adequate information is available on natural history and the clinical risk associated with untreated ICDVT. We investigated the rate and clinical consequences of untreated ICDVT in symptomatic outpatients. All pts were managed in line with the PCUS strategy. Those without proximal DVT and likely PCP and/or altered Dd were eligible for the study and received an immediately subsequent blind CUS examination of the calf deep veins (CDV) by a different operator. The results of this investigation were disclosed only after 3 months. All pts received a call phone by a doctor 3 m after inclusion.The CDV examination was performed in 439 [201 M; median age 67.6 y (range 19–96)] symptomatic subjects with negative PCUS at presentation. In 5 of them CDV examination was completely inconclusive. A thrombosis in at least one CDV segment was diagnosed in 66 subjects who were negative at PCUS strategy (15.0%). Examination was considered inconclusive in many single CDV segments. At 3 m 3/66 (4.5%) subjects with ICDVT diagnosis had complications: one pulmonary embolism occurred before the 2nd visit of the PCUS strategy, 1 proximal and 1 distal DVT were diagnosed before 3rd m. Two complications (1 proximal and 1 distal DVT) were reported at 3 m in subjects negative at both PCUS and CCUS. PCUS and CCUS strategies failed in 5 (1.1%; CI 0.4–2.6) and 2 (0.4%; 0.1–1.6) out of the 439 symptomatic subjects, respectively; the latter would have required 3 m anticoagulation in 15% more subjects. These results seem to be against the need for a CCUS in symptomatic outpatients.
Disclosure of interest: none declared.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
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