Abstract
The crucial point for all therapeutic considerations is the exact estimation of the age of the thrombus. Until the present, phlebography, an invasive technique, has been the gold standard in venous diagnostics. The intention of this study was to investigate the efficiency of duplex color-coded ultrasound (DCCU). The authors evaluated ultrasonic criteria for an acute thrombus by using experimental thrombi in rats. They screened for venous thrombosis in 20 acutely amputated lower extremities from vascular patients. Findings of ultrasound were controlled by histopathologic thrombus examination. Finally 40 traumatologic patients were examined for deep vein thrombosis with DCCU after an immobilization of one leg. Comparison of ultrasound and histopathology revealed that three phenomena can be safely discriminated: type I (acute thrombus one to ten days), type II (three to five days), and type III (> six days). After immobilization of lower extremities they found 3 type I (acute) thrombi in 40 patients. Age estimation of venous thrombi by duplex color-coded ultrasound is possible. DCCU is a rapid and noninvasive technique; instead or in addition to phlebography, it may be extremely helpful in decision making for therapeutic strategy.
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