Diagnosis of deep vein thrombosis recurrence: Ultrasound criteria

Abstract Introduction Recurrent deep vein thrombosis (DVT) is often suspected in patients after anticoagulant drug withdrawal. The clinical signs can be confused with the onset of post-thrombotic syndrome. For these reasons, diagnosis of DVT recurrence must rely on an accurate method. Materials and methods In order to assess this challenging clinical issue, we performed an overview of the literature regarding ultrasound criteria for the diagnosis of recurrent DVT through a Medline search, which included articles published from January 1, 1980 to February 20, 2017. Results Eighty-eight publications were found based on the defined keywords, of which nine articles with a relevant abstract were selected. By searching the reference lists of these nine articles, we obtained another 27 relevant articles. A new non-compressible vein or an increase in the diameter of a previously thrombosed vein segment by > 4 mm are sufficient to confirm the diagnosis of DVT recurrence. In contrast, an increase in diameter of Conclusions Ultrasound remains the most useful test for the diagnosis of recurrent DVT. Further imaging tests need to be validated.