Phlébologie Annales Vasculaires    Société Française de Phlébologie
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2020, 73, 1, p.72-77

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Chapter 3. Ultrasound assessment of acute superficial vein thrombosis.

Auteurs/Authors : Gillet J.L.

Résumé :

In patients presenting a clinical suspicion of Superficial Vein Thrombosis (SVT), an ultrasound examination by venous Duplex Ultrasound (DUS) is essential in order to:
- confirm the diagnosis of SVT. Although the clinical features are usually suggestive because of the presence of an indurated, inflammatory and painful venous cord, differential diagnoses are possible;
- define the actual location and extent of the SVT; an extension is often underestimated by the clinical examination, particularly at the upper third of the thigh and at the popliteal fossa, whereas an extension at the sapheno-femoral or sapheno-popliteal junction is a criterion of severity;
- diagnose or rule out a concomitant deep vein thrombosis, which may not be contiguous with the SVT, including in the contralateral lower limb;
- define the etio-pathogenic context by distinguishing SVTs occurring in varicose veins from SVTs occurring in nonvaricose veins.
When suspecting SVT, the need for a complete DUS examination has been clearly expressed in the joint recommendations made by the International Union of Phlebology, the International Union of Angiology and the European Venous Forum.

Summary :

In patients presenting a clinical suspicion of Superficial Vein Thrombosis (SVT), an ultrasound examination by venous Duplex Ultrasound (DUS) is essential in order to:
- confirm the diagnosis of SVT. Although the clinical features are usually suggestive because of the presence of an indurated, inflammatory and painful venous cord, differential diagnoses are possible;
- define the actual location and extent of the SVT; an extension is often underestimated by the clinical examination, particularly at the upper third of the thigh and at the popliteal fossa, whereas an extension at the sapheno-femoral or sapheno-popliteal junction is a criterion of severity;
- diagnose or rule out a concomitant deep vein thrombosis, which may not be contiguous with the SVT, including in the contralateral lower limb;
- define the etio-pathogenic context by distinguishing SVTs occurring in varicose veins from SVTs occurring in nonvaricose veins.
When suspecting SVT, the need for a complete DUS examination has been clearly expressed in the joint recommendations made by the International Union of Phlebology, the International Union of Angiology and the European Venous Forum.

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