Yield of ultrasonography in patients with or without post-thrombotic syndrome for diagnosis of suspected recurrent ipsilateral deep vein thrombosis

Background: The yield of ultrasonography in patients with or without post-thrombotic syndrome (PTS) presenting with a suspected recurrent ipsilateral deep vein thrombosis (DVT) is unknown.

Methods: Patients with a first unprovoked DVT received standard anticoagulation for 5 to 7 months. Then, they were assessed for PTS using the Villalta scale (score equal or >5) and followed for up to 18 months. Yield of ultrasonography for recurrent ipsilateral DVT was defined as the number of confirmed DVT divided by the number of suspicions. Outcomes were compared between patients without or with PTS.

Results and discussion: A total of 452 patients with a symptomatic proximal DVT were included. During follow-up, there were 144 suspicions of recurrent ipsilateral DVT, which were confirmed in 38 patients (26.4%). The confirmation rate of recurrent ipsilateral DVT was 25.6% (23/90) in patients without PTS as compared with 27.8% (15/54) in patients with PTS (P = .84). Our study supports a similar yield of ultrasonography to diagnose recurrent ipsilateral DVT in patients off anticoagulation therapy with or without PTS as defined by 5 or more points on the Villalta scale.