Short- and medium-term duplex sonography follow-up of deep venous thrombosis of the lower limbs.

PURPOSE

We conducted this study to assess the progression or regression of venous thrombi during and after treatment and to search for criteria of embolism risk.

METHODS

We prospectively studied 75 patients with lower limb deep venous thrombosis. We used B-mode sonography for the diagnosis and follow-up of these thrombi. Pulmonary scintigraphy was performed at days 1 and 10. We evaluated the topography, echogenicity, and structure of the thrombus; the location and wall attachment of its head; and the vein diameter. Each venous segment was semiquantitatively scored as follows: 0, no thrombosis; 1, partially obstructive thrombosis; or 2, complete thrombosis.

RESULTS

The decreases in the total thrombosis score were 4%, 11%, 51%, 72%, and 84% on days 5, 10, 30, 90, and 365 (1 year), respectively. Pulmonary embolism occurred in 27 patients, of whom 16 were asymptomatic. Thrombi in iliac veins exhibited a slower regression rate than those in calf and femoral veins. Pulmonary embolism occurred in 54% of patients with versus 24% of patients without a floating thrombus head.

CONCLUSIONS

Sonography is useful for the early detection of thrombus progression and the evaluation of embolism risk, which seems to be greater in patients with a floating thrombus head.