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Advances in the Diagnosis of Venous Thromboembolism: A Literature Review

1
Department of Medicine, BronxCare Hospital Center a Clinical Affiliate of Mt Sinai Health Systems and Academic affiliate of Icahn School of Medicine, Bronx, NY 10457, USA
2
Division of the Pulmonary and Critical Care, BronxCare Hospital Center a Clinical Affiliate of Mt Sinai Health Systems and Academic Affiliate of Icahn School of Medicine, Bronx, NY 10457, USA
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(6), 365; https://doi.org/10.3390/diagnostics10060365
Received: 29 April 2020 / Revised: 28 May 2020 / Accepted: 30 May 2020 / Published: 2 June 2020
(This article belongs to the Special Issue Venous Thrombosis (DVT/VTE): From Bench to Bedside)
The incidence of venous thromboembolism (VTE), including lower extremity deep vein thrombosis (DVT) and pulmonary embolism (PE) is increasing. The increase in suspicion for VTE has lowered the threshold for performing imaging studies to confirm diagnosis of VTE. However, only 20% of suspected cases have a confirmed diagnosis of VTE. Development of pulmonary embolism rule-out criteria (PERC) and update in pre-test probability have changed the paradigm of ruling-out patient with low index of suspicion. The D-dimer test in conjunction to the pre-test probability has been utilized in VTE diagnosis. The age appropriate D-dimer cutoff and inclusion of YEARS algorithm (signs of the DVT, hemoptysis and whether PE is the likely diagnosis) for the D-dimer cutoff have been recent updates in the evaluation of suspected PE. Multi-detector computed tomography pulmonary angiography (CTPA) and compression ultrasound (CUS) are the preferred imaging modality to diagnose PE and DVT respectively. The VTE diagnostic algorithm do differ in pregnant individuals. The prerequisite of avoiding excessive radiation has recruited planar ventilation-perfusion (V/Q) scan as preferred in pregnant patients to evaluate for PE. The modification of CUS protocol with addition of the Valsalva maneuver should be performed while evaluating DVT in pregnant individual. View Full-Text
Keywords: VTE diagnosis; review VTE; pregnancy and VTE VTE diagnosis; review VTE; pregnancy and VTE
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MDPI and ACS Style

Patel, H.; Sun, H.; Hussain, A.N.; Vakde, T. Advances in the Diagnosis of Venous Thromboembolism: A Literature Review. Diagnostics 2020, 10, 365.

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