Current standings in diagnostic management of acute venous thromboembolism: Still rough around the edges

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• 作者：T. van der Hulle ; ^{t.van_der_hulle@lumc.nl" class="auth_mail" title="E-mail the corresponding author} ; C.E.A. Dronkers ; M.V. Huisman ; F.A. Klok
• 关键词：Venous thromboembolism ; Diagnosis ; Fibrin fibrinogen degradation products ; Decision support techniques ; Diagnostic imaging
• 刊名：Blood Reviews
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：30
• 期：1
• 页码：21-26
• 全文大小：400 K

文摘

Signs and symptoms of acute deep vein thrombosis (DVT) and pulmonary embolism (PE) are notoriously non-specific. Therefore, diagnostic management algorithms have been developed, consisting of a clinical decision rule (CDR), D-dimer testing and an imaging test, that allow safe diagnostic management and the exclusion of VTE in clinical practice. However, several challenges still remain: adherence to the diagnostic algorithms, accurate diagnosis of recurrent VTE and reducing the radiation exposure associated with computed tomography pulmonary angiography for suspected PE. In this clinically oriented review, we will provide an overview of current diagnostic algorithms for suspected DVT and PE and focus on recent advances including strategies to improve adherence to recommended algorithms, age-dependent D-dimer threshold and novel imaging techniques.