Non‐invasive Screening for Venous Thromboembolic Disease

Abstract

Venous thromboembolism is an important cause of morbidity and mortality, and the clinical signs are notoriously unreliable. Two safe and reliable non‐invasive techniques have therefore been developed for the diagnosis of DVT namely thermography, and the measurement of serum levels of fibrinogen degradation fragment E (FgE). A total of 93 medical patients were studied using these techniques and the results were compared with the phlebographic appearances of the lower limbs. In 91 patients, the thermographic findings were identical to the radiological findings; there was one false‐positive thermograph, and one false‐negative thermograph, which occurred in a case of isolated calf vein thrombosis. There were 59 subjects without evidence of DVT only one of whom had an FgE level greater than 400 μg/l., whereas 17 of the 19 subjects with extensive DVT proximal to the knee, had levels greater than 400 μg/l. In eight subjects with clinical and perfusion lung scan evidence of pulmonary emboli, the FgE levels were all greater than 800 μg/l. These findings demonstrate the reliability of a combination of these two non‐invasive diagnostic techniques in the detection of DVT. The local lesion may be identified using thermography, whereas elevated levels of FgE indicate the likelihood of extensive thrombosis with embolization.