Clinical value of simple proximal vein ultrasonography plus D-dimer vs whole-leg colour doppler ultrasonography for the diagnosis of deep vein thrombosis

In a prospective, multi-centre trial «Bernardi E, Camporese G, Büller HR, Siragusa S, Im...»1 2098 out of 2465 consequtive symptomatic outpatients with suspected first episode of deep vein thrombosis were randomized to undergo 2-point or whole-leg ultrasonography. Patients who had normal 2-point ultrasonography were tested for D-dimer. Patients with normal D-dimer levels were spared further investigations, whereas those with abnormal D-dimer level were scheduled for a repeat 2-point ultrasonography at 1 week. The 3-month incidence of objectively confirmed symptomatic venous thromboembolism after normal findings in initial workup was 0.9% (7/801), 95% CI 0.3% to 1.8% in the 2-point strategy group and 1.2% (9/763), 95% CI 0.5% to 2.2%) in the whole leg strategy group. Only 4 patients were lost to follow-up.