VENOUS DUPLEX IMAGING FOLLOW-UP OF ACUTE SYMPTOMATIC DEEP-VEIN THROMBOSIS OF THE LEG

Purpose: The purpose of this study was to evaluate the rate of resolut ion of deep vein thrombosis (DVT) in the leg, by means of duplex imagi ng, in patients with symptoms during a 6-month period after initial di agnosis. Methods: Seventy-three limbs in 69 patients with acute DVT di agnosed by duplex imaging received conventional heparin and warfarin t reatment and underwent subsequent duplex studies 1, 4, 12, and 24 week s after the initial diagnosis. The objectives of the study were to doc ument (1) the rate or complete resolution of DVT, (2) the proportion o f unstable, floating thrombi, and (3) the development of chronic damag e as a result of vessel wall scarring. Results: The rate of normalizat ion of DVT 6 months after diagnosis was 78% in the common femoral vein , 70% in the superficial femoral vein, 75% in the popliteal vein, and 70% in the calf veins examined at the scheduled intervals. Twenty-six percent of thrombi were considered unstable on the baseline examinatio n. The average number of days necessary for these thrombi to become st able was 10.7 days. Damage to the vessel wall or valves was documented in 44% of the patients. Conclusions: Rates of resolution of DVT were similar for the different veins of the leg studied. There was a high p roportion of unstable thrombi, which present a high potential risk of embolization. Serial duplex scanning after DVT renders important infor mation with regard to thrombus resolution, propagation, and attachment to the vein wall.