Deep Venous Thrombosis: Recent Advances and Optimal Investigation with US

HomeRadiologyVol. 211, No. 1 PreviousNext State of the ArtDeep Venous Thrombosis: Recent Advances and Optimal Investigation with USJames D. Fraser, David R. AndersonJames D. Fraser, David R. AndersonAuthor Affiliations1From the Departments of Radiology (J.D.F.) and Medicine (D.R.A.), Queen Elizabeth II Health Sciences Centre, 1278 Tower Rd, Halifax, Nova Scotia, Canada B3H 2Y9. Received February 12, 1998; revision requested March 18; final revision received September 9; accepted October 19. D.R.A. is a Research Scholar of the Canadian Heart and Stroke Foundation. Address reprint requests to J.D.F.James D. FraserDavid R. AndersonPublished Online:Apr 1 1999https://doi.org/10.1148/radiology.211.1.r99ap459MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In References 1 Ginsberg JS. Management of venous thromboembolism. N Engl J Med 1996; 335:1816-1828. Crossref, Medline, Google Scholar2 Salzman EW, Hirsh J. The epidemiology, pathogenesis, and natural history of venous thrombosis. In: Colman RW, Hirsh J, Marder VJ, Salzman EW, eds. Hemostasis and thrombosis: basic principles and clinical practice. 3rd ed. Philadelphia, Pa: Lippincott, 1995; 1275-1297. Google Scholar3 Lensing AWA, Hirsh J, Buller HR. Diagnosis of venous thrombosis. In: Colman RW, Hirsh J, Marder VJ, Salzman EW, eds. Hemostasis and thrombosis: basic principles and clinical practice. 3rd ed. Philadelphia, Pa: Lippincott, 1995; 1297-1322. Google Scholar4 Anderson FA, Wheeler HB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism: the Worcester DVT study. Arch Intern Med 1991; 151:993-938. Google Scholar5 Hyers TM, Hull RD, Weg JG. Antithrombotic therapy for venous thromboembolic disease. Chest 1995; 108(suppl 1):335S-351S. Crossref, Medline, Google Scholar6 Cogo A, Lensing AWA, Wells P, Prandoni P, Buller HR. Noninvasive objective tests for the diagnosis of clinically suspected deep-vein thrombosis. Haemostasis 1995; 25:27-39. Medline, Google Scholar7 Cronan JJ. Venous thromboembolic disease: the role of US. Radiology 1993; 186:619-630. Link, Google Scholar8 Cogo A, Lensing AWA, Prandoni P, Hirsh J. Distribution of venous thrombosis in patients with symptomatic deep vein thrombosis: implications for simplifying the diagnostic process with compression ultrasound. Arch Intern Med 1993; 153:2777-2780. Crossref, Medline, Google Scholar9 Birdwell BG, Raskob GE, Whitsett TL, et al. The clinical validity of normal compression ultrasonography in outpatients suspected of having deep venous thrombosis. Ann Intern Med 1998; 128:1-7. Crossref, Medline, Google Scholar10 DeBaleu ME, Ochner A. Phlegmasia cerulea dolens associated with thrombophlebitis: case reports and review of the literature. Surgery 1966; 59:997-1007. Medline, Google Scholar11 Brockman SK, Basko JS. Phlegmasia cerulea dolens. Surg Gynecol Obstet 1965; 121:1347-1356. Medline, Google Scholar12 Blow S, Sager P. Venous gangrene. Acta Chir Scand 1976; 141:272-277. Google Scholar13 Ginsberg JS, Brill-Edwards P, Burrows RF, et al. Venous thrombosis during pregnancy: leg and trimester of presentation. Thromb Haemost 1992; 67:519-520. Crossref, Medline, Google Scholar14 Mueh JR, Herbst KD, Rapaport SSI. Thrombosis in patients with the lupus anticoagulant. Ann Intern Med 1980; 92:156-159. Crossref, Medline, Google Scholar15 Lockshin MD. Antiphospholipid antibody syndrome. Rheum Dis Clin North Am 1994; 20:45-59. Crossref, Medline, Google Scholar16 Asherson RA, Khamashta MA, Ordi-Ros J, et al. The "primary" antiphospholipid syndrome: major clinical and serological features. Medicine (Baltimore) 1989; 68:366-374. Crossref, Medline, Google Scholar17 Clagett GP, Anderson FA, Heit J, Levine MN, Wheeler HB. Prevention of venous thromboembolism. Chest 1995; 108(suppl 1):312S-334S. Crossref, Medline, Google Scholar18 Robinson KS, Anderson DR, Gross M, et al. Accuracy of screening compression ultrasonography and the clinical examination for the diagnosis of deep vein thrombosis following hip or knee arthroplasty. Can J Surg ; (in press). Google Scholar19 Robinson KS, Anderson DR, Gross M, et al. Ultrasonographic screening before hospital discharge for deep venous thrombosis after arthroplasty: the post-arthroplasty screening study. Ann Intern Med 1997; l27:439-445. Google Scholar20 Simioni P, Prandoni P, Lensing AW, et al. The risk of recurrent venous thromboembolism in patients with an Arg506—>Gln mutation in the gene for factor V (factor V Leiden). N Engl J Med 1997; 336:399-403. Crossref, Medline, Google Scholar21 D'Angelo A, Selhub J. Homocysteine and thrombotic disease. Blood 1997; 90:1-11. Crossref, Medline, Google Scholar22 Levine MN, Hirsh I, Gent M, et al. Optimal duration of oral anticoagulant therapy: a randomized trial comparing four weeks with three months of warfarin in patients with proximal deep vein thrombosis. Thromb Haemost 1993; 74:606-611. Google Scholar23 Schulman S, Rhedin AS, Lindmarker P, et al. A comparison of six weeks with six months of oral anticoagulant therapy after a first episode of venous thromboembolism. N Engl J Med 1995; 332:1661-1665. Crossref, Medline, Google Scholar24 Prandoni P, Lensing AWA, Buller HR, et al. Deep-vein thrombosis and the incidence of subsequent symptomatic cancer. N Engl J Med 1992; 327:1128-1133. Crossref, Medline, Google Scholar25 Hull RD, Raskob GE, Rosenbloom D, et al. Heparin for 5 days as compared with 10 days in the initial treatment of proximal venous thrombosis. N Engl J Med 1990; 322:1260-1264. Crossref, Medline, Google Scholar26 Gallus AS, Jackaman I, Tillett J, Mills W, Wycherley A. Safety and efficacy of warfarin started early after submassive venous thrombosis or pulmonary embolism. Lancet 1986; 2:1293-1296. Medline, Google Scholar27 Weitz JI. Low-molecular-weight heparins. N Engl J Med 1997; 337:688-698. Crossref, Medline, Google Scholar28 Warkentin TE, Levine MN, Hirsh J, et al. Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med 1995; 332:1330-1335. Crossref, Medline, Google Scholar29 Lensing AW, Prins MH, Davidson BL, Hirsh J. Treatment of deep venous thrombosis with low-molecular-weight heparins: a meta-analysis. Arch Intern Med 1995; 155:601-607. Crossref, Medline, Google Scholar30 The Columbus Investigators. Low-molecular-weight heparin in the treatment of patients with venous thromboembolism. N Engl J Med 1997; 337:657-662. Crossref, Medline, Google Scholar31 Simonneau G, Sors H, Charbonnier B, et al. A comparison of low-molecular-weight heparin with unfractionated heparin for acute pulmonary embolism. N Engl J Med 1997; 337:663-669. Crossref, Medline, Google Scholar32 Levine M, Gent M, Hirsh J, et al. A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis. N Engl J Med 1996; 334:667-681. Google Scholar33 Koopman MMW, Prandoni P, Piovella F, et al. Treatment of venous thrombosis with intravenous unfractionated heparin administered in the hospital as compared with subcutaneous low-molecular-weight heparin administered at home. N Engl J Med 1996; 334:682-687. Crossref, Medline, Google Scholar34 Hirsh J, Hoak J. Management of deep vein thrombosis and pulmonary embolism. Circulation 1996; 93:2212-2245. Crossref, Medline, Google Scholar35 Rogers LQ, Lutcher CL. Streptokinase therapy for deep vein thrombosis: a comprehensive review of the English literature. Am J Med 1990; 88:389-395. Crossref, Medline, Google Scholar36 Kakkar VV, Lawrence D. Hemodynamic and clinical assessment after therapy of acute deep vein thrombosis. Am J Surg 1985; 10:54-63. Google Scholar37 Levine MN, Goldhaber SZ, Gore JM, Hirsh J, Califf RM. Hemorrhagic complications of thrombolytic therapy in the treatment of myocardial infarction and venous thromboembolism. Chest 1995; 108(suppl 1):291S-301S. Crossref, Medline, Google Scholar38 Barnes RW, Wu KK, Hoak JC. Fallibility of the clinical diagnosis of venous thrombosis. JAMA 1975; 234:605-607. Crossref, Medline, Google Scholar39 Haeger K. Problems of acute venous thrombosis: the interpretation of signs and symptoms. Angiology 1969; 20:219-223. Crossref, Medline, Google Scholar40 Wells PS, Hirsh J, Anderson DR, et al. Accuracy of clinical assessment of deep-vein thrombosis. Lancet 1995; 345:1326-1330. Crossref, Medline, Google Scholar41 Wells PS, Anderson DR, Bormanis J, et al. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet 1997; 350:1795-1798. Crossref, Medline, Google Scholar42 de Valois JC, van Schaik CC, Verzijlbergen F, van Ramshorst B, Eikelboom BC, Meuwissen OJA. Contrast venography: from gold standard to 'golden backup' in clinically suspected deep vein thrombosis. Eur J Radiol 1990; 11:131-137. Crossref, Medline, Google Scholar43 Wheeler HB, Anderson FA, Jr. Diagnostic methods for deep vein thrombosis. Haemostasis 1995; 25:6-26. Medline, Google Scholar44 Pedersen LM, Lerche A, Jorgensen M, Urhammer S, Steenberg P, Jensen R. Follow-up study of patients with clinically suspected deep venous thrombosis and a normal venogram. J Intern Med 1993; 234:457-460. Crossref, Medline, Google Scholar45 Levine MN, Hirsh J, Gent M, et al. Prevention of deep vein thrombosis after elective hip surgery: a randomized trial comparing low molecular weight heparin with standard unfractionated heparin. Ann Intern Med 1991; 114:545-551. Crossref, Medline, Google Scholar46 Lensing AWA, Prandoni P, Büller HR, Casara D, Cogo A, Wouter ten Cate J. Lower extremity venography with iohexol: results and complications. Radiology 1990; 177:503-505. Link, Google Scholar47 Bettmann MA, Robbins A, Braun SD, Wetzner S, Dunnick NR, Finkelstein J. Contrast venography of the leg: diagnostic efficacy, tolerance, and complication rates with ionic and nonionic contrast media. Radiology 1987; 165:113-116. Link, Google Scholar48 Hull RD, Hirsh J, Carter CJ, et al. Diagnostic efficacy of impedance plethysmography for clinically suspected deep vein thrombosis. Ann Intern Med 1985; 102:21-28. Crossref, Medline, Google Scholar49 Huisman MV, Buller HR, ten Cate JW, Vreeken J. Serial impedance plethysmography for suspected deep venous thrombosis in outpatients. N Engl J Med 1986; 314:823-828. Crossref, Medline, Google Scholar50 Hull R, Hirsh J, Sackett DL, et al. Replacement of venography in suspected venous thrombosis by impedance plethysmography and 125I-fibrinogen leg scanning. Ann Intern Med 1981; 94:12-15. Crossref, Medline, Google Scholar51 Cogo A, Lensing AW, Prandoni P, Buller HR, Girolami A, ten-Cate JW. Comparison of real-time B-mode ultrasonography and Doppler ultrasound with contrast venography in the diagnosis of venous thrombosis in symptomatic outpatients. Thromb Haemost 1993; 70:404-407. Crossref, Medline, Google Scholar52 Heijboer H, Buller HR, Lensing AW, Turpie AG, Colly LP, ten Cate JW. A comparison of real-time compression ultrasonography with impedance plethysmography for the diagnosis of deep-vein thrombosis in symptomatic outpatients. N Engl J Med 1993; 329:1365-1369. Crossref, Medline, Google Scholar53 Anderson DR, Lensing AWA, Wells PS, et al. Limitations of impedance plethysmography in the diagnosis of clinically suspected deep vein thrombosis. Ann Intern Med 1993; 118:25-30. Crossref, Medline, Google Scholar54 Lensing AW, Prandoni P, Brandjes D, et al. Detection of deep-vein thrombosis by real-time B-mode ultrasonography. N Engl J Med 1989; 320:342-345. Crossref, Medline, Google Scholar55 White RH, McGahan JP, Daschbach MM, Hartling RP. Diagnosis of deep-vein thrombosis using duplex ultrasound. Ann Intern Med 1989; 111:297-304. Crossref, Medline, Google Scholar56 Talbot SR. B-mode evaluation of peripheral veins. Semin Ultrasound CT MR 1988; 9:295-319. Medline, Google Scholar57 Wells PS, Hirsh J, Anderson DR, et al. Comparison of the accuracy of impedance plethysmography and compression ultrasonography in outpatients with clinically suspected deep vein thrombosis: a two centre paired-design prospective trial. Thromb Haemost 1995; 75:1423-1427. Google Scholar58 Lensing AW, Doris CI, McGrath FP, et al. A comparison of compression ultrasound with color Doppler ultrasound for the diagnosis of symptomless postoperative deep vein thrombosis. Arch Intern Med 1997; 157:765-768. Crossref, Medline, Google Scholar59 Davidson BL, Elliott CG, Lensing AW. Low accuracy of color Doppler ultrasound in the detection of proximal leg vein thrombosis in asymptomatic high-risk patients: the RD heparin arthroplasty group. Ann Intern Med 1992; 117:735-738. Crossref, Medline, Google Scholar60 Simons GR, Skibo LK, Polak JF. Utility of leg ultrasonography in suspected symptomatic isolated calf deep venous thrombosis. Am J Med 1995; 99:43-47. Crossref, Medline, Google Scholar61 Atri M, Herba MJ, Reinhold C, et al. Accuracy of sonography in the evaluation of calf deep vein thrombosis in both postoperative surveillance and symptomatic patients. AJR 1996; 166:1361-1367. Crossref, Medline, Google Scholar62 Porter JM, Moneta GL, International Consensus Committee on Chronic Venous Disease. Reporting standards in venous disease: an update. J Vasc Surg 1995; 21:635-645. Crossref, Medline, Google Scholar63 Raghavendra BN, Rosen RJ, Lam S, Riles T, Horii SC. Deep venous thrombosis: detection by high-resolution real-time ultrasonography. Radiology 1984; 152:789-793. Link, Google Scholar64 Raghavendra BN, Horii SC, Hilton S, Sabramanyam BR, Rosen RJ, Lam S. Deep venous thrombosis: detection by probe compression of veins. J Ultrasound Med 1986; 5:89-95. Crossref, Medline, Google Scholar65 Bundens WP, Bergan JJ, Halasz NA, Murray J, Drehobl M. The superficial femoral vein. JAMA 1995; 274:1296-1298. Crossref, Medline, Google Scholar66 Cronan JJ, Leen V. Recurrent deep venous thrombosis: limitations of US. Radiology 1989; 170:739-742. Link, Google Scholar67 Prandoni P, Lensing AWA, Cattelan AM, Cogo A, Cuppini S, Ruol A. Outcome of abnormal compression ultrasonography after acute deep venous thrombosis (DVT) and its implications for diagnosis of recurrent DVT (abstr). Thromb Haemost 1991; 66:1175. Google Scholar68 Killewich LA, Bedford GR, Beach KW, Strandness DE. Spontaneous lysis of deep venous thrombi: rate and outcome. J Vasc Surg 1989; 9:89-97. Crossref, Medline, Google Scholar69 Lutter KS, Kerr TM, Roedersheimer LR, Lohr JM, Sampson MG, Cranley JJ. Superficial thrombophlebitis diagnosed by duplex scanning. Surgery 1991; 110:42-46. Medline, Google Scholar70 Kearon C, Julian JA, Newman TE, Ginsberg JS. Noninvasive diagnosis of deep venous thrombosis: McMaster diagnostic imaging practice guidelines initiative. Ann Intern Med 1998; 128:663-677. Crossref, Medline, Google Scholar71 Rose SC, Zwiebel WJ, Nelson BD, et al. Symptomatic lower extremity deep venous thrombosis: accuracy, limitations, and role of color duplex flow imaging in diagnosis. Radiology 1990; 175:639-644. Link, Google Scholar72 Wells PS, Lensing AW, Davidson BL, Prins MH, Hirsh J. Accuracy of ultrasound for the diagnosis of deep vein thrombosis in asymptomatic patients after orthopedic surgery: a meta-analysis. Ann Intern Med 1995; 122:47-53. Crossref, Medline, Google Scholar73 Magnusson M, Bengt EI, Kalebo P, Sivertsson R. Is colour Doppler ultrasound a sensitive screening method in diagnosing deep vein thrombosis after hip surgery?. Thromb Haemost 1996; 75:242-245. Crossref, Medline, Google Scholar74 Kakkar VV, Howe CT, Flanc C, Clarke MB. Natural history of postoperative deep-vein thrombosis. Lancet 1969; 2:230-232. Crossref, Medline, Google Scholar75 Lagerstedt CI, Olsson CG, Fagher BO, Oqvist BW, Albrechtsson U. Need for long-term anticoagulant treatment in symptomatic calf-vein thrombosis. Lancet 1985; 2:515-518. Medline, Google Scholar76 Cogo A, Lensing AWA, Koopman MMW, et al. Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study. BMJ 1998; 316:17-20. Crossref, Medline, Google Scholar77 Heijboer H, Ginsberg JS, Buller HR, Lensing AWA, Colly LP, ten Cate JW. The use of the d-dimer test in combination with serial non-invasive versus serial non-invasive testing alone for the diagnosis of deep-vein thrombosis. Thromb Haemost 1992; 67:510-513. Crossref, Medline, Google Scholar78 Hillner BE, Philbrick JT, Becker DM. Optimal management of suspected lower-extremity deep vein thrombosis: an evaluation with cost assessment of 24 management strategies. Arch Intern Med 1992; 152:165-175. Crossref, Medline, Google Scholar79 Bounameaux H, Cirafici P, de Moerloose P, et al. Measurement of d-dimer in plasma as diagnostic aid in suspected pulmonary embolism. Lancet 1991; 337:196-200. Crossref, Medline, Google Scholar80 Turkstra F, van Beek JR, ten Cate JW, Buller HR. Reliable rapid blood test for the exclusion of venous thromboembolism in symptomatic outpatients. Thromb Haemost 1996; 76:9-11. Crossref, Medline, Google Scholar81 Bounameaux H, Schneider PA, Reber G, Moerloose P, Krahenbuhl B. Measurement of plasma d-dimer for diagnosis of deep venous thrombosis. Am J Clin Pathol 1989; 91:82-85. Crossref, Medline, Google Scholar82 Boneu B, Bes G, Pelzer H, Sie P, Boccalon H. d-Dimers, thrombin antithrombin III complexes and prothrombin fragment 1+2: diagnostic value in clinically suspected deep vein thrombosis. Thromb Haemost 1991; 65:28-32. Crossref, Medline, Google Scholar83 Heaton DC, Billings JD, Hickton CM. Assessment of d-dimer assays for the diagnosis of deep vein thrombosis. J Lab Clin Med 1987; 110:588-591. Medline, Google Scholar84 Wells PS, Brill-Edwards P, Stevens P, et al. A novel and rapid whole-blood assay for d-dimer in patients with clinically suspected deep vein thrombosis. Circulation 1995; 91:2184-2187. Crossref, Medline, Google Scholar85 Wells PS, Anderson DR, Bormanis J, Guy F, Mitchell M, Lewandowski B. SimpliRED d-dimer can reduce the diagnostic tests in suspected deep vein thrombosis. Lancet 1998; 351:1405-1406. Crossref, Medline, Google Scholar86 Ginsberg JS, Kearon C, Douketis J, et al. The use of d-dimer testing and impedance plethysmographic examination in patients with clinical indications of deep vein thrombosis. Arch Intern Med 1997; 157:1077-1081. Crossref, Medline, Google Scholar87 Vaccaro JP, Cronan JJ, Dorfman GS. Outcome analysis of patients with normal compression US examinations. Radiology 1990; 175:645-649. Link, Google Scholar88 Pezzullo JA, Perkins AB, Cronan JJ. Symptomatic deep vein thrombosis: diagnosis with limited compression US. Radiology 1996; 198:67-70. Link, Google Scholar89 Poppiti R, Papanicolaou G, Perese S, Weaver FA. Limited B-mode venous imaging versus complete color-flow duplex venous scanning for detection of proximal deep venous thrombosis. J Vasc Surg 1995; 22:553-557. Crossref, Medline, Google Scholar90 Anderson DR, Wells PS, Stiell I, et al. Management of patients with suspected deep vein thrombosis in the emergency department: use of a clinical diagnosis model to safely avoid the need for urgent radiological investigation. Arch Intern Med ; (in press). Google Scholar91 Hammes DW, Bura A, Mazzolai L, et al. Subcutaneous heparin compared with continuous intravenous heparin administration for the initial treatment of deep vein thrombosis. Ann Intern Med 1992; 116:279-284. Crossref, Medline, Google Scholar92 Rosen MP, McArdle C. Controversies in the use of lower extremity sonography in the diagnosis of acute deep vein thrombosis and a proposal for a unified approach. Semin Ultrasound CT MR 1997; 18:362-368. Crossref, Medline, Google Scholar93 Cronan JJ. Deep venous thrombosis: one leg or both legs?. Radiology 1996; 200:323-324. Link, Google Scholar94 Sheiman RG, McArdle CR. Bilateral lower extremity US in the patient with unilateral symptoms of deep venous thrombosis: assessment of need. Radiology 1995; 194:171-173. Link, Google Scholar95 Prandoni P, Cogo A, Bernardi E, et al. A simple ultrasound approach for detection of recurrent proximal-vein thrombosis. Circulation 1993; 88:1730-1735. Crossref, Medline, Google Scholar96 vanErkel AR, vanRossum AB, Bloem JL, Kievit J, Pattynama PMT. Spiral CT angiography for suspected pulmonary embolism: a cost-effectiveness analysis. Radiology 1996; 201:29-36. Link, Google Scholar97 The PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism: results of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). JAMA 1990; 263:2753-2759. Crossref, Medline, Google Scholar98 Hull RD, Hirsh J, Carter CJ, et al. Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med 1983; 98:891-899. Crossref, Medline, Google Scholar99 Turkstra F, Kuijer PMM, van Beek EJR, Brandjes DPM, ten Cate JW, Buller HR. Diagnostic utility of ultrasonography of leg veins in patients suspected of having pulmonary embolism. Ann Intern Med 1997; 126:775-781. Crossref, Medline, Google Scholar100 Perrier A, Bounameaux H, Morabia A, et al. Diagnosis of pulmonary embolism by a decision analysis-based strategy including clinical probability, d-dimer levels and ultrasonography: a management study. Arch Intern Med 1996; 156:531-536. Crossref, Medline, Google Scholar101 Wells P, Ginsberg JS, Anderson DR, et al. The use of a clinical model to safely manage patients with suspected pulmonary embolism. Ann Intern Med ; (in press). Google Scholar102 Ferretti GR, Bosson JL, Buffax PD, et al. Acute pulmonary embolism: role of helical CT in 164 patients with intermediate probability at ventilation-perfusion scintigraphy and normal results at duplex US of the legs. Radiology 1997; 205:453-458. Link, Google Scholar103 Prescott SM, Tikoff G. Deep venous thrombosis of the upper extremity: a reappraisal. Circulation 1979; 59:350-355. Crossref, Medline, Google Scholar104 Swinton NW, Edgett JW, Hall RJ. Primary subclavian-axillary vein thrombosis. Circulation 1968; 38:737-745. Crossref, Medline, Google Scholar105 Demester SL, Pritchard JS, Piedad OH, Cordasco EM, Taherj S. Upper extremity thrombosis: etiology and prognosis. Angiology 1982; 48:743-755. Google Scholar106 Hill SL, Berry RE. Subclavian vein thrombosis: a continuing challenge. Surgery 1990; 108:1-9. Medline, Google Scholar107 Horattas MC, Wright DJ, Fenton AH, et al. Changing concepts of deep venous thrombosis of the upper extremity: report of a series and review of the literature. Surgery 1988; 104:561-567. Medline, Google Scholar108 Monreal M, Lafoz E, Ruiz J, Valls R, Alastrue A. Upper-extremity deep venous thrombosis and pulmonary embolism: a prospective study. Chest 1991; 99:280-283. Crossref, Medline, Google Scholar109 Hingorani A, Ascher E, Hanson J, et al. Upper extremity versus lower extremity deep venous thrombosis. Am J Surg 1997; 174:214-217. Crossref, Medline, Google Scholar110 Prandoni P, Polistena P, Bernardi E, et al. Upper-extremity deep vein thrombosis: risk factors, diagnosis, and complications. Arch Intern Med 1997; 157:357-362. Crossref, Medline, Google Scholar111 Harley DP, White RA, Nelson RJ, Mehringer CM. Pulmonary embolism secondary to venous thrombosis of the arm. Am J Surg 1984; 147:221-224. Crossref, Medline, Google Scholar112 Black MD, French GJ, Rasuli P, Bouchard AC. Upper extremity deep venous thrombosis: underdiagnosed and potentially lethal. Chest 1993; 103:1887-1890. Crossref, Medline, Google Scholar113 Hung SSJ. Deep vein thrombosis of the arm associated with malignancy. Cancer 1989; 64:531-535. Crossref, Medline, Google Scholar114 Gaitini D, Kaftori JK, Pery M, Engel A. High-resolution real-time ultrasonography: diagnosis and follow-up of jugular and subclavian vein thrombosis. J Ultrasound Med 1988; 7:621-627. Crossref, Medline, Google Scholar115 Kerr TM, Lutter KS, Moeller DM, et al. Upper extremity venous thrombosis diagnosed by duplex scanning. Am J Surg 1990; 160:202-206. Crossref, Medline, Google Scholar116 Gooding GAW, Hightower DR, Moore EH, Dillon WP, Lipton MJ. Obstruction of the superior vena cava or subclavian veins: sonographic diagnosis. Radiology 1986; 159:663-665. Link, Google Scholar117 Hightower DR, Gooding GAW. Sonographic evaluation of the normal response of subclavian veins to respiratory maneuvers. Invest Radiol 1985; 20:517-520. Crossref, Medline, Google Scholar118 Machi J, Sigel B, Roberts AB, Kahn MB. Oversaturation of color may obscure small intraluminal partial occlusions in color Doppler imaging. J Ultrasound Med 1994; 13:735-741. Crossref, Medline, Google ScholarArticle HistoryPublished in print: Apr 1999 FiguresReferencesRelatedDetailsCited ByThrombosis Journal, Vol. 20, No. 1European Journal of HaematologyIndian Journal of SurgeryBiomacromolecules, Vol. 22, No. 6Clinical and Applied Thrombosis/Hemostasis, Vol. 27Acta Ortopédica Brasileira, Vol. 29, No. 6Medical Visualization, Vol. 25, No. 4GLOBAL JOURNAL FOR RESEARCH ANALYSISVenous Thrombosis and Hypercoagulability in the Abdomen and Pelvis: Causes and Imaging FindingsMichael C. Olson, Meghan G. Lubner, Christine O. Menias, Vincent M. Mellnick, Lori Mankowski Gettle, David H. Kim, Khaled M. Elsayes, Perry J. Pickhardt, 24 April 2020 | RadioGraphics, Vol. 40, No. 3Current Opinion in Critical Care, Vol. 26, No. 6Journal of Thrombosis and Haemostasis, Vol. 18, No. 3Journal of Ultrasound in Medicine, Vol. 38, No. 4Magnetic Resonance in Medicine, Vol. 81, No. 3Clinical Medicine, Vol. 19, No. 4The British Journal of Radiology, Vol. 398Journal of Anaesthesiology Clinical Pharmacology, Vol. 33, No. 2Magnetic Resonance in Medicine, Vol. 75, No. 2Blood Coagulation & Fibrinolysis, Vol. 27, No. 3Historical Evolution of Imaging Techniques for the Evaluation of Pulmonary Embolism: RSNA Centennial ArticleMilad Yazdani, Charles T. Lau, Jason K. Lempel, Ruchi Yadav, Ahmed H. El-Sherief, Joseph T. Azok, Rahul D. Renapurkar, 14 July 2015 | RadioGraphics, Vol. 35, No. 4Journal of Thrombosis and Thrombolysis, Vol. 40, No. 2Thrombosis Journal, Vol. 13, No. 1Critical Care, Vol. 19, No. 1Applied RadiologyClinical and Applied Thrombosis/Hemostasis, Vol. 19, No. 1Journal of Community Hospital Internal Medicine Perspectives, Vol. 3, No. 1Journal of Clinical Ultrasound, Vol. 40, No. 1Thrombosis Research, Vol. 129, No. 2The Annals of The Royal College of Surgeons of England, Vol. 94, No. 7Cochrane Database of Systematic ReviewsJournal of Medical Ultrasound, Vol. 19, No. 3Journal of Computer Assisted Tomography, Vol. 35, No. 5Orthopedics, Vol. 34, No. 3International Journal of Healthcare Information Systems and Informatics, Vol. 6, No. 4Magnetic Resonance in Medicine, Vol. 64, No. 1Der Chirurg, Vol. 81, No. 5Internal and Emergency Medicine, Vol. 5, No. 2Journal of Thrombosis and Haemostasis, Vol. 8, No. 4Angiology, Vol. 61, No. 1American Journal of Roentgenology, Vol. 194, No. 5Wiener klinische Wochenschrift Education, Vol. 4, No. 2focus neurogeriatrie, Vol. 3, No. 3Magnetic Resonance Imaging, Vol. 27, No. 5British Journal of Hospital Medicine, Vol. 70, No. 7Der Radiologe, Vol. 48, No. 10Internal and Emergency Medicine, Vol. 3, No. 4Radiología, Vol. 50, No. 2Emergency Medicine Clinics of North America, Vol. 26, No. 3Seminars in Nuclear Medicine, Vol. 38, No. 6Angiology, Vol. 59, No. 5Journal of Parenteral and Enteral Nutrition, Vol. 32, No. 4Modern Rheumatology, Vol. 18, No. 4Annals of Vascular Diseases, Vol. 1, No. 1Medical Journal of Australia, Vol. 189, No. 3Evidence-based Practice in Radiology: Steps 3 and 4—Appraise and Apply Diagnostic Radiology Literature1Jonathan D. Dodd, 1 February 2007 | Radiology, Vol. 242, No. 2Journal of Clinical Ultrasound, Vol. 35, No. 7Emergency Radiology, Vol. 14, No. 6Spine, Vol. 32, No. 17International Journal of Palliative Nursing, Vol. 13, No. 12Expert Review of Cardiovascular Therapy, Vol. 5, No. 3The Japanese Journal of Phlebology, Vol. 18, No. 3Journal of Clinical Ultrasound, Vol. 34, No. 6EMC - Cardiologie, Vol. 1, No. 1EMC - Radiologie et imagerie médicale - Cardiovasculaire - Thoracique - Cervicale, Vol. 1, No. 1Clinical Radiology, Vol. 61, No. 1Journal of Vascular Surgery, Vol. 44, No. 6Critical Care Medicine, Vol. 34, No. 3Journal for Vascular Ultrasound, Vol. 30, No. 1American Journal of Roentgenology, Vol. 186, No. 6Clinica Chimica Acta, Vol. 354, No. 1-2Journal of Critical Care, Vol. 20, No. 4Journal of Critical Care, Vol. 20, No. 4Journal of Critical Care, Vol. 20, No. 4Progress in Pediatric Cardiology, Vol. 21, No. 1Critical Care Medicine, Vol. 33, No. 7Ultrasound Quarterly, Vol. 21, No. 4Journal of Anatomy, Vol. 206, No. 6Medical Journal of Australia, Vol. 182, No. 9Annals of Vascular Surgery, Vol. 18, No. 5Journal de Radiologie, Vol. 85, No. 6Clinical Imaging, Vol. 28, No. 6Emergency Medicine Clinics of North America, Vol. 22, No. 3EMC - Cardiologie-Angéiologie, Vol. 1, No. 1Journal of Vascular Surgery, Vol. 40, No. 4Radiologic Clinics of North America, Vol. 42, No. 2Techniques in Vascular and Interventional Radiology, Vol. 7, No. 2Circulation, Vol. 109, No. 12_suppl_1The Journal of Bone and Joint Surgery-American Volume, Vol. 86, No. 4Variations in Lower Limb Venous Anatomy: Implications for US Diagnosis of Deep Vein Thrombosis1Daniel J. Quinlan, , Raza Alikhan, , Philip Gishen, , and Paul S. Sidhu, 1 August 2003 | Radiology, Vol. 228, No. 2Deep Venous Thrombosis: Diagnosis by Using Venous Enhanced Subtracted Peak Arterial MR Venography versus Conventional Venography1Douglas G. W. Fraser, , Alan R. Moody, , Ian R. Davidson, , Anne L. Martel, , and Paul S. Morgan, 1 March 2003 | Radiology, Vol. 226, No. 3New England Journal of Medicine, Vol. 349, No. 13The Journal of Trauma: Injury, Infection, and Critical Care, Vol. 54, No. 6The Journal of Trauma: Injury, Infection, and Critical Care, Vol. 54, No. 6Angiology, Vol. 54, No. 1The Journal of Bone and Joint Surgery-American Volume, Vol. 85, No. 7Journal of Ultrasound in Medicine, Vol. 22, No. 5Combined CT Venography and Pulmonary Angiography: A Comprehensive Review1Douglas S. Katz, , Peter A. Loud, , Dennis Bruce, , Adam M. Gittleman, , Richard Mueller, , Donald L. Klippenstein, , and Zachary D. Grossman, 1 October 2002 | RadioGraphics, Vol. 22, No. suppl_1Der Radiologe, Vol. 42, No. 3Radiologic Clinics of North America, Vol. 40, No. 1Ultrasound in Medicine & Biology, Vol. 28, No. 6British Journal of Surgery, Vol. 87, No. 11Journal of Thoracic Imaging, Vol. 17, No. 1Journal of Neuroimaging, Vol. 12, No. 2American Journal of Roentgenology, Vol. 178, No. 4Emergency Medicine Clinics of North America, Vol. 19, No. 4Academic Radiology, Vol. 8, No. 9ANZ Journal of Surgery, Vol. 71, No. 11Australasian Radiology, Vol. 45, No. 2American Journal of Roentgenology, Vol. 176, No. 5American Journal of Roentgenology, Vol. 177, No. 21999 Plenary Session: Friday Imaging Symposium Venous US of Lower-Extremity Deep Venous Thrombosis: When Is US Insufficient?1Damian E. Dupuy, 1 July 2000 | RadioGraphics, Vol. 20, No. 4The Journal of Emergency Medicine, Vol. 19, No. 3Techniques in Vascular and Interventional Radiology, Vol. 3, No. 1Current Opinion in Hematology, Vol. 7, No. 5Vascular Surgery, Vol. 34, No. 2American Journal of Roentgenology, Vol. 175, No. 4American Journal of Roentgenology, Vol. 175, No. 5Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 211, No. 1 Metrics Altmetric Score PDF download