The Use of Point-of-Care Ultrasound (POCUS) in the Diagnosis of Deep Vein Thrombosis
Dimitrios Varrias, Leonidas Palaiodimos, Prasanth Balasubramanian, Christian A. Barrera, Peter C. Nauka, Angelos Arfaras-Melainis, C Zamora, Phaedon D. Zavras, Marzio Napolitano, Perminder Gulani, George Ntaios, Robert Faillace, Benjamin Galen
Abstract
Acute lower extremity proximal deep venous thrombosis (DVT) requires accurate diagnosis and treatment in order to prevent embolization and other complications. Point-of-care ultrasound (POCUS), a clinician performed, and clinician interpreted bedside ultrasound examination has been increasingly used for DVT evaluation mainly in the urgent and critical care setting, but also in the ambulatory clinics and the medical wards. Studies have demonstrated that POCUS has excellent diagnostic accuracy for acute proximal DVT when performed by well-trained users. However, there is significant heterogeneity among studies on the necessary extent of training and universally acceptable standardized education protocols are needed. In this review, we summarize the evidence that supports the use of POCUS to diagnose acute proximal DVT and focus on methodology and current technology, sensitivity and specificity, pre-test probability and the role of D-dimer, time and resources, education, limitations, and future directions.