Diagnosis of Venous Thrombosis in the Lower Limbs

Abstract

Three methods of thrombosis diagnosis were compared in 97 patients: ascending phlebography, the ¹²⁵I-fibrinogen test, and strain gauge plethysmography. The fibrinogen test showed the highest frequency of thromboses and plethysmography the lowest. Phlebography gives a morphological diagnosis, but is not so reliable in muscular, superficial and deep femoral veins. It makes great demands on the X-ray department and is therefore seldom suitable as a screening method. It will continue to be the reference method for the diagnosis of thrombosis. The fibrinogen test measures the radioactive uptake, is simple and suited for screening examinations and sequential studies, but the risk of hepatitis must be remembered. The clinical relevance of positive fibrinogen test is discussed. We believe that calf vein thrombi may grow and reach the size where embolization is possible. Plethysmography measures the function of the deep venous system. It can be used for screening examinations and sequential studies. The thrombi diagnosed interfere with venous function and lie proximally to the calf. The method is valuable in acute iliofemoral thromboses. On the basis of diagnostic discrepancies between fibrinogen test and phlebography in dextran-treated patients the possibility is discussed that thrombi formed in a dextran milieu may lyse more rapidly than other thrombi.