Expert-Based Narrative Review on Compression UltraSonography (CUS) for Diagnosis and Follow-Up of Deep Venous Thrombosis (DVT)
Deep venous thrombosis (DVT) is a pathological condition that develops when a thrombus forms within the deep venous system. Typically, it involves the lower limbs and, less frequently, the upper extremities or other unusual districts such as cerebral or splanchnic veins. While leg DVT itself is rare...
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2025-01-01
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| author | Mario D’Oria Laura Girardi Ahmed Amgad Mohab Sherif Gabriele Piffaretti Barbara Ruaro Cristiano Calvagna Philip Dueppers Sandro Lepidi Marco Paolo Donadini |
| author_facet | Mario D’Oria Laura Girardi Ahmed Amgad Mohab Sherif Gabriele Piffaretti Barbara Ruaro Cristiano Calvagna Philip Dueppers Sandro Lepidi Marco Paolo Donadini |
| author_sort | Mario D’Oria |
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| description | Deep venous thrombosis (DVT) is a pathological condition that develops when a thrombus forms within the deep venous system. Typically, it involves the lower limbs and, less frequently, the upper extremities or other unusual districts such as cerebral or splanchnic veins. While leg DVT itself is rarely fatal and occasionally can lead to limb-threatening implications, its most fearsome complication, namely pulmonary embolism, is potentially fatal and significantly contributes to increased healthcare costs and impaired quality of life in affected patients and caregivers. Thanks to its high accuracy, ease of use, and safety profile, duplex ultrasound (DUS), particularly compression ultrasound (CUS), has emerged as the first-line imaging modality for DVT diagnosis. The evaluation of suspected DVT needs a multifaceted approach, and in this context, CUS rapidly became a key diagnostic tool owing to its many unique advantages. Its central role in the diagnostic algorithm of suspected DVT is clearly established in the latest clinical practice guidelines from the European Society for Vascular Surgery and the American Society of Haematology. Indeed, DUS effectively visualizes blood flow and identifies abnormalities like clot formation with high sensitivity (typically exceeding 90% for proximal DVT) and specificity (often approaching 100% for proximal DVT). Additionally, CUS is non-invasive, readily available at the bedside, and avoids radiation exposure, resulting in an ideal method for various clinical settings. CUS has been shown to have a substantial role not only in the diagnosis of an acute DVT but also in the follow-up of its management. Moreover, this method can provide a prognostic assessment, mostly in terms of risk stratification for recurrent thrombosis and/or for potential complications, such as post-thrombotic syndrome. In summary, given its established benefits, CUS is a technique that many physicians should be familiar with, especially those working in emergency departments, intensive care units, or general wards. When needed, healthcare operators with more advanced US skills (such as radiologists, angiologists, or vascular surgeons) may be called upon to provide a second look in case of uncertainty and/or need for additional information. |
| format | Article |
| id | doaj-art-c4ea213e926a43b1b7ea8e2257c43c68 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-c4ea213e926a43b1b7ea8e2257c43c682025-01-10T13:16:40ZengMDPI AGDiagnostics2075-44182025-01-011518210.3390/diagnostics15010082Expert-Based Narrative Review on Compression UltraSonography (CUS) for Diagnosis and Follow-Up of Deep Venous Thrombosis (DVT)Mario D’Oria0Laura Girardi1Ahmed Amgad2Mohab Sherif3Gabriele Piffaretti4Barbara Ruaro5Cristiano Calvagna6Philip Dueppers7Sandro Lepidi8Marco Paolo Donadini9Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, 34127 Trieste, ItalyResearch Center on Thromboembolic Diseases and Antithrombotic Treatment, Department of Medicine and Surgery, University of Insubria, 21100 Varese, ItalyFaculty of Medicine, Helwan University, Cairo 11792, EgyptFaculty of Medicine, Helwan University, Cairo 11792, EgyptVascular Surgery, Department of Medicine and Surgery, School of Medicine, University of Insubria, 21100 Varese, ItalyDepartment of Pulmonology, University Hospital of Cattinara, 34149 Trieste, ItalyDivision of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, 34127 Trieste, ItalyDepartment of Vascular Surgery, Kantonsspital St. Gallen, 9000 St. Gallen, SwitzerlandDivision of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, 34127 Trieste, ItalyResearch Center on Thromboembolic Diseases and Antithrombotic Treatment, Department of Medicine and Surgery, University of Insubria, 21100 Varese, ItalyDeep venous thrombosis (DVT) is a pathological condition that develops when a thrombus forms within the deep venous system. Typically, it involves the lower limbs and, less frequently, the upper extremities or other unusual districts such as cerebral or splanchnic veins. While leg DVT itself is rarely fatal and occasionally can lead to limb-threatening implications, its most fearsome complication, namely pulmonary embolism, is potentially fatal and significantly contributes to increased healthcare costs and impaired quality of life in affected patients and caregivers. Thanks to its high accuracy, ease of use, and safety profile, duplex ultrasound (DUS), particularly compression ultrasound (CUS), has emerged as the first-line imaging modality for DVT diagnosis. The evaluation of suspected DVT needs a multifaceted approach, and in this context, CUS rapidly became a key diagnostic tool owing to its many unique advantages. Its central role in the diagnostic algorithm of suspected DVT is clearly established in the latest clinical practice guidelines from the European Society for Vascular Surgery and the American Society of Haematology. Indeed, DUS effectively visualizes blood flow and identifies abnormalities like clot formation with high sensitivity (typically exceeding 90% for proximal DVT) and specificity (often approaching 100% for proximal DVT). Additionally, CUS is non-invasive, readily available at the bedside, and avoids radiation exposure, resulting in an ideal method for various clinical settings. CUS has been shown to have a substantial role not only in the diagnosis of an acute DVT but also in the follow-up of its management. Moreover, this method can provide a prognostic assessment, mostly in terms of risk stratification for recurrent thrombosis and/or for potential complications, such as post-thrombotic syndrome. In summary, given its established benefits, CUS is a technique that many physicians should be familiar with, especially those working in emergency departments, intensive care units, or general wards. When needed, healthcare operators with more advanced US skills (such as radiologists, angiologists, or vascular surgeons) may be called upon to provide a second look in case of uncertainty and/or need for additional information.https://www.mdpi.com/2075-4418/15/1/82compression ultrasounddeep vein thrombosisdiagnostic techniquesduplex ultrasoundvenous thromboembolismpost-thrombotic syndrome |
| spellingShingle | Mario D’Oria Laura Girardi Ahmed Amgad Mohab Sherif Gabriele Piffaretti Barbara Ruaro Cristiano Calvagna Philip Dueppers Sandro Lepidi Marco Paolo Donadini Expert-Based Narrative Review on Compression UltraSonography (CUS) for Diagnosis and Follow-Up of Deep Venous Thrombosis (DVT) Diagnostics compression ultrasound deep vein thrombosis diagnostic techniques duplex ultrasound venous thromboembolism post-thrombotic syndrome |
| title | Expert-Based Narrative Review on Compression UltraSonography (CUS) for Diagnosis and Follow-Up of Deep Venous Thrombosis (DVT) |
| title_full | Expert-Based Narrative Review on Compression UltraSonography (CUS) for Diagnosis and Follow-Up of Deep Venous Thrombosis (DVT) |
| title_fullStr | Expert-Based Narrative Review on Compression UltraSonography (CUS) for Diagnosis and Follow-Up of Deep Venous Thrombosis (DVT) |
| title_full_unstemmed | Expert-Based Narrative Review on Compression UltraSonography (CUS) for Diagnosis and Follow-Up of Deep Venous Thrombosis (DVT) |
| title_short | Expert-Based Narrative Review on Compression UltraSonography (CUS) for Diagnosis and Follow-Up of Deep Venous Thrombosis (DVT) |
| title_sort | expert based narrative review on compression ultrasonography cus for diagnosis and follow up of deep venous thrombosis dvt |
| topic | compression ultrasound deep vein thrombosis diagnostic techniques duplex ultrasound venous thromboembolism post-thrombotic syndrome |
| url | https://www.mdpi.com/2075-4418/15/1/82 |
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