[Contribution of the hemostasis laboratory in the diagnosis of deep venous thrombosis].

Venography is still the gold standard for objective diagnosis of deep venous thrombosis (DVT). However, this investigation is costly and time-consuming, demands technical expertise and has potential side-effects. To reduce the number of phlebographies a simple, rapid and reliable screening test for exclusion of DVT would be greatly appreciated. In many studies markers of activated coagulation and fibrinolysis such as thrombin-antithrombin complex (TAT), prothrombin fragment 1 + 2 (F 1 + 2) and D-dimers, respectively, were investigated with respect to their potential use as screening tests. Especially D-dimers as assessed by ELISA have turned out to have high sensitivity and negative predictive value for DVT and could therefore serve as screening test for exclusion of DVT. However, most of the easier, more rapid D-dimer Latex tests which would be better suited for emergency situations as well as the TAT- and F 1 + 2-ELISA tests are according to most studies not sufficiently sensitive. In the present article the significance of the different activation markers in the diagnostic approach of DVT is discussed based on the literature.