Vascular Surgery

Vascular
Surgery

   

• B.
  Wolf, D.M. Nichols^* and 
  J. L. Duncan[ Departments of General Surgery
  and ^* Radiology, Raigmore Hospital,
  Inverness, UK]
  
  Safety
  of a Single Duplex Scan to Exclude Deep Venous
  Thrombosis
  
  Br.
  Jour. of  Sur.
  Volume 87, No.11, November 2000, Pgs- 1525-1528
  
   
  
  Guidelines advocate that a negative
  ultrasonographic scan needs to be followed by
  venography, or a repeat scan to detect potentially
  missed calf vein thrombosis.
  
   
  
  This
  study evaluates whether anticoagulation can safely
  be withheld on the basis of a single negative duplex
  scan.
  
   
  
  A
  retrospective analysis of duplex scan reports, case
  notes and questionnaires returned by general
  practitioners of patients suspected to have DVT. The
  main outcome measure was occurrence of an adverse
  thromboembolic event, a symptomatic DVT or pulmonary
  embolism, within 3 months of a negative duplex scan.
  
   
  
  537
  patients had 709 leg scans performed for suspected
  DVT. Among 352 patients, who had 429 negative leg
  scans, four possible adverse events were identified.
  [1.1% per patient and 0.9% per leg] suggesting it is
  safe to withhold anticoagulation after a single
  negative scan.