Negative Ultrasound Study Can Rule Out Upper Extremity DVT

MedicalResearch.com Interview with:
Dott. Michelangelo Sartori

U.O. di Angiologia e Malattie della Coagulazione
Azienda Ospedaliera di Bologna
Policlinico Sant’Orsola Malpighi
Bologna

Medical Research: What is the background for this study? What are the main findings?

Response: The safety of withholding anticoagulation only on the basis of ultrasound imaging has not been evaluated in patients with suspected (Upper Extremity Deep Vein Thromobsis) UEDVT. The purpose of this management study was to evaluate the failure rate of ultrasound testing for UEDVT diagnosis in outpatients. Our data show that, similarly to the lower extremity, a negative complete ultrasound assessment of the upper extremity can safely exclude DVT. We found a 3-month VTE rate of 0.6% after a negative ultrasound and such figure is not different from the 3-month VTE incidence in management studies for lower limb DVT.  Thus anticoagulant therapy can be withheld for clinically suspected UEDVT after negative ultrasound examination without further testing in the ambulatory office setting.

Medical Research: What should clinicians and patients take away from your report?

Response: Outpatients are often seen in angiology or radiology clinics that often can rely only on clinical examination and ultrasonography. We show that, similarly to the lower extremity, a negative complete ultrasound assessment of the upper extremity can safely exclude DVT.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Some limitations of the present study should be acknowledged. Firstly this is single center study with experienced vascular physicians and our results should be repeated in other centres to further confirm their clinical impact.

Citation:

Sartori M, Migliaccio L, Favaretto E, et al. Whole-Arm Ultrasound to Rule Out Suspected Upper-Extremity Deep Venous Thrombosis in Outpatients. JAMA Intern Med. Published online May 11, 2015. doi:10.1001/jamainternmed.2015.1683.

MedicalResearch.com Interview with: Dott. Michelangelo Sartori (2015). Negative Ultrasound Study Can Rule Out Upper Extremity DVT