High percentage of non-diagnostic compression ultrasonography results and the diagnosis of ipsilateral recurrent proximal deep vein thrombosis: a rebuttal.

Establishing a diagnosis of recurrent deep vein thrombosis (RDVT) by compression ultrasonography (CUS) is often difficult because persistent abnormal findings of the deep veins are common after a first episode of DVT. This may lead to a high percentage of potential misclassified patients with ipsilateral RDVT. The objective of the study is to evaluate the diagnostic management of ipsilateral RDVT by CUS in daily practice. This study was a retrospective cohort study of 90 consecutive patients, who had a CUS because of clinically suspected ipsilateral RDVT. The medical records and CUS reports were reviewed according to established diagnostic CUS criteria for RDVT. During the study period, in 52 of the 90 patients (58 %) the diagnosis was accurately ruled out and anticoagulant treatment was withheld. According to our predefined criteria in only 9 patients (10%) the diagnosis of ipsilateral RDVT could be definitively established. In the remaining 29 patients (32%) the criteria of RDVT were not met by documentation in reports and a definitive diagnosis could not be made. In 29 out of 90 patients (32 %) who had a CUS because of a suspected ipsilateral RDVT, the diagnosis could not be reproduced with certainty by reviewing the CUS reports according to the predefined criteria. This high percentage of non-diagnostic CUS indicates the urgent need for more accurate diagnostic methods in patients presenting with suspected ipsilateral RDVT. High percentage of non diagnostic CUS in recurrent DVT 65