Compression with a pocket-sized ultrasound device to diagnose proximal deep vein thrombosis

Am J Emerg Med. 2018 Jul;36(7):1262-1264. doi: 10.1016/j.ajem.2018.03.076. Epub 2018 Apr 3.


Introduction: Compression ultrasonography (CUS) is a validated technique for the diagnosis of deep venous thrombosis (DVT), but has never been studied with pocket-sized ultrasound device (PUD). The main objective of this study was to assess the diagnostic performance of CUS made by emergency physicians (EPs) using a PUD.

Materials: This was a prospective, diagnostic test assessment, single-center study. Patients underwent VCU performed by a trained EP with PUD (CUS-PUD) for searching proximal DVT (PDVT) and were then seen by an expert vascular physician who blindly performed a duplex venous ultrasound, which was the criterion standard. CUS-PUD's diagnostic performance was evaluated by sensitivity (Se), specificity (Sp), and positive and negative predictive values (PPV and NPV).

Results: The sample included 57 patients of whom 56 were analyzed. Eleven (20%) PDVT were diagnosed with CUS-PUD: 7 (64%) femoral and 4 (36%) popliteal. The CUS-PUD's Se was 100% [72%; 100%], Sp 100% [92%; 100%]. The PPV was 100% [74%; 100%], and the NPV was 100% [90%; 100%].

Conclusion: CUS-PUD performed with a pocket-sized ultrasound appears to be feasible in emergency practice for the diagnosis of proximal DVT. A study with a larger sample size will have to describe the accuracy.

Keywords: Emergency medicine; Point-of-care systems; Ultrasonography; Venous thrombosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital*
  • Female
  • Femoral Vein / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Popliteal Vein / diagnostic imaging*
  • Pressure
  • Prospective Studies
  • Reproducibility of Results
  • Ultrasonography / instrumentation*
  • Venous Thrombosis / diagnosis*