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Diagnostic and therapeutic aspects of deep vein thrombosis

Abstract

51 out-patients presenting with calf-vein thrombosis were randomized to treatment with heparin for five days or heparin with subsequent warfarin for three months. Among 23 patients in the warfarin-group no recurrence occurred, whereas 8 of the 28 patients (29%) in the non-warfarin group had recurrent thrombo-embolism during the first 90 days. It is concluded that patients with symptomatic calf-vein thrombi should be treated with both heparin and oral anticoagulation. In a prospective study of X-ray contrast media, post-phlebographic reactions occurred in 7 of 19 patients (37%) investigated with a high-osmolality contrast medium metrizoate whereas no such reaction occurred among 24 patients investigated with a low-osmolality contrast medium iohexol. Thus, low-osmolatily contrast media should preferably be used at phlebography. 396 out-patients with suspected venous thrombosis were investigated with the {sup 99m}Tc-plasmin test, physical examination and phlebography. The plasmin test has a high sensitivity (95%) but a low specificity (47%), and was frequently abnormal when clinical signs of inflammation were present. Clinical signs could not accurately predict if thrombosis was present, although subpopulations of patients with high or low probability of venous thrombosis could be identified. 112 patients with suspected DVT were investigated with thermography. Both sensitivity and specificity were low (77%  More>>
Authors:
Publication Date:
Dec 31, 1992
Product Type:
Thesis/Dissertation
Report Number:
LUMEDW-MEMA-1038-1-100-1992
Reference Number:
SCA: 550601; PA: AIX-24:001286; SN: 93000913101
Resource Relation:
Other Information: TH: Doctoral Dissertation (MD).; PBD: 1992
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; THROMBOSIS; DIAGNOSIS; ANTICOAGULANTS; BLOOD COAGULATION; CONTRAST MEDIA; EXPERIMENTAL DATA; PATIENTS; THERAPY; TRACER TECHNIQUES; VEINS; 550601; UNSEALED RADIONUCLIDES IN DIAGNOSTICS
OSTI ID:
10110262
Research Organizations:
Lund Univ. (Sweden). Dept. of Internal Medicine
Country of Origin:
Sweden
Language:
English
Other Identifying Numbers:
Other: ON: DE93609306; TRN: SE9200321001286
Availability:
OSTI; NTIS; INIS
Submitting Site:
SWDN
Size:
[50] p.
Announcement Date:
Jun 30, 2005

Citation Formats

Lagerstedt, C. Diagnostic and therapeutic aspects of deep vein thrombosis. Sweden: N. p., 1992. Web.
Lagerstedt, C. Diagnostic and therapeutic aspects of deep vein thrombosis. Sweden.
Lagerstedt, C. 1992. "Diagnostic and therapeutic aspects of deep vein thrombosis." Sweden.
@misc{etde_10110262,
title = {Diagnostic and therapeutic aspects of deep vein thrombosis}
author = {Lagerstedt, C}
abstractNote = {51 out-patients presenting with calf-vein thrombosis were randomized to treatment with heparin for five days or heparin with subsequent warfarin for three months. Among 23 patients in the warfarin-group no recurrence occurred, whereas 8 of the 28 patients (29%) in the non-warfarin group had recurrent thrombo-embolism during the first 90 days. It is concluded that patients with symptomatic calf-vein thrombi should be treated with both heparin and oral anticoagulation. In a prospective study of X-ray contrast media, post-phlebographic reactions occurred in 7 of 19 patients (37%) investigated with a high-osmolality contrast medium metrizoate whereas no such reaction occurred among 24 patients investigated with a low-osmolality contrast medium iohexol. Thus, low-osmolatily contrast media should preferably be used at phlebography. 396 out-patients with suspected venous thrombosis were investigated with the {sup 99m}Tc-plasmin test, physical examination and phlebography. The plasmin test has a high sensitivity (95%) but a low specificity (47%), and was frequently abnormal when clinical signs of inflammation were present. Clinical signs could not accurately predict if thrombosis was present, although subpopulations of patients with high or low probability of venous thrombosis could be identified. 112 patients with suspected DVT were investigated with thermography. Both sensitivity and specificity were low (77% and 66% respectively) and thermography therefore seems not to be useful in the diagnosis of symptomatic venous thrombosis. Long-term sequelae after a first episode of venous thrombosis are mostly mild as long as 6 years after the diagnosis. Venous function correlated to the extension of the thrombus but no to subjective symptoms. Clinical signs at diagnosis could not predict the late outcome. During the six years of follow-up, 28% of the patients had recurrent thrombosis. (158 refs.) (au).}
place = {Sweden}
year = {1992}
month = {Dec}
}