Does venous microemboli detection add to the interpretation of D-dimer values following orthopedic surgery?

The identification of risk factors for deep venous thrombosis (DVT) followi ng orthopedic surgery remains unclear. We have investigated the relationshi p between plasma levels of D-dimer (DD), the presence or absence of microem boli 1day after surgery, and the occurence of DVT 7 days after total hip or knee replacement. The prevalence of DVT was 25 (13.3%) among 188 patients and was lower in 112 patients with DD < 2808 ng mL(-1) than in the 56 patie nts with higher DD levels: respectively, 8.0% vs. 21.4% (p < 0.05), D-dimer is not suitable for individual estimation of DVT risk. Microemboli were fo und in 112 (60%) of 186 subjects. The presence/absence or the frequency of the microemboli showed no relationship with the occurence of DVT, Last, whe n evaluating the risk of DVT in orthopedic surgery, microemboli detection d oes not add to the interpretation of DD concentration. (C) 1999 World Feder ation for Ultrasound in Medicine & Biology.