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General Session V - Venous Thromboembolism and IVC Filters

General Session V - Venous Thromboembolism and IVC Filters

Quickshot: Investigating the Necessity of Bilateral Femoral Vein Ultrasound for Patients with Unilateral Symptomatic Deep Venous Thrombosis

Tuesday, March 5, 2024
9:38 AM – 9:44 AM EST
Location: Tampa Bay Ballroom Salons 1-4
Objective: Venous duplex ultrasound (VDUS) is the accepted initial imaging study to rule out lower extremity deep venous thrombosis (DVT) for patients presenting with symptoms such as pain and swelling. In accordance with the Intersocietal Accreditation Commission (IAC) policies for vascular laboratories, many institutions require technicians to additionally assess the asymptomatic contralateral femoral vein. To date, there is no literature supporting this recommendation. Therefore, the aim of this study is to investigate the necessity of examining the asymptomatic contralateral femoral vein in patients undergoing a unilateral lower extremity VDUS to rule out DVT by (1) defining the prevalence of DVT in the asymptomatic contralateral limb and (2) identifying risk factors that may predispose patients to developing a DVT in the asymptomatic limb.

Methods:

We retrospectively reviewed the results of consecutive unilateral lower extremity VDUS for inpatients and outpatients from January 2023 to July 2023. Patient data including age, sex, symptoms, risk factors for DVT, and indications for the VDUS were collected. The primary outcome was frequency of DVT in the asymptomatic contralateral femoral vein. Categorical and continuous data were compared using X2 and Student’s t-tests, respectively. For all tests, a P-value of < 0.05 was considered statistically significant.

Results:

371 patients (170 inpatient vs. 201 outpatient) with unilateral DVT symptoms who underwent VDUS during the study period were identified. Right leg symptoms were present in 186 (50%) patients and left leg symptoms were present in 185 (50%) patients. There was no difference in the prevalence of DVT risk factors or ipsilateral VDUS findings between inpatients and outpatients (Table I). Overall, 119 (32%) patients were found to have a DVT including 118 (31%) unilateral and 1 (0.08%) bilateral. The patient with bilateral acute DVTs was an inpatient admitted for irritable bowel syndrome. VDUS demonstrated a DVT in the femoral vein of the symptomatic limb and calf veins of the asymptomatic limb. There were no patients with a DVT isolated to the asymptomatic contralateral femoral vein.

Conclusions:

Scanning the asymptomatic contralateral femoral vein is not necessary in inpatients or outpatients presenting with unilateral DVT symptoms, regardless of risk factors. A single-extremity study will suffice in most cases without resulting in a decline in DVT detection.

    Abstract Podium Presenter(s)

  • Moira A. McGevna

    Student Researcher
    New York University, New Jersey, United States