D-dimer Strategy in Thrombosis Exclusion

1998 ◽  
Vol 79 (01) ◽  
pp. 32-37 ◽  
Author(s):  
H. Trillaud ◽  
S. Labrouche ◽  
P. Gauthier ◽  
S. Javorschi ◽  
P. Bernard ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Gold Standard ◽  
Quantitative Methods ◽  
Rapid Methods ◽  
Radiologic Examination ◽  
The Cost ◽  
D Dimer

SummaryDD are now recognized as a valuable tool to screen patients suspected of deep venous thrombosis or pulmonary embolism before carrying out a gold standard radiologic examination. The newest methods available claim to be able to ascertain the absence of thrombosis, but they have yet to prove their efficiency. We compared the performances of 3 reference ELISA methods (D-DI Asserachrom™ Stago, D-dimer Enzygnost™ Behring and Dimertest GOLD EIA™ Agen), 5 recent rapid methods (VIDAS D-Dimer™ bioMérieux, Instant IA™ Stago, Simplired™ Agen, Nycocard D-dimer™ Nycomed and Accuclot D-Dimer™ Sigma Diagnostics) and two routine latex methods (Dimertest™ American Diagnostica and FDP-Slidex™ bioMérieux) in 100 patients. One of the rapid quantitative methods was demonstrated to have a level of efficiency comparable to that of ELISA methods. Finally, the cost and efficiency of different strategies were evaluated, the association of a routine latex method with the VIDAS D-Dimer™ bioMérieux being proven to be the most efficient.

Analysis of Measured D-dimer Levels for Detection of Deep Venous Thrombosis and Pulmonary Embolism After Spinal Surgery

2011 ◽  
Vol 24 (4) ◽  
pp. E35-E39 ◽  
Author(s):  
Toyomi Yoshiiwa ◽  
Masashi Miyazaki ◽  
Chikahiro Takita ◽  
Ichiro Itonaga ◽  
Hiroshi Tsumura
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Spinal Surgery ◽  
D Dimer

scholarly journals The D-Dimer Test for Deep Venous Thrombosis: Gold Standards and Bias in Negative Predictive Value

2003 ◽  
Vol 49 (4) ◽  
pp. 570-574 ◽  
Author(s):  
John T Philbrick ◽  
Steven Heim
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
English Language ◽  
False Negative ◽  
True Negative ◽  
Language Studies ◽  
D Dimer

Abstract Background: Because venous ultrasound (US) fails to fully image the calf veins, there is the potential for US gold standard studies to classify patients with calf deep venous thrombosis (DVT) in the nondiseased category, causing bias in test index calculations. A false increase in negative predictive value (NPV) is especially likely because calf DVT false-negative tests will be counted in the numerator along with the true-negative tests in NPV calculations. We verified the presence and magnitude of this bias for the d-dimer test. Methods: We abstracted data on overall (calf and thigh) and thigh-only test sensitivity, specificity, and NPV from the six English language studies published between March 1995 and October 2001 that compared d-dimer to a gold standard (GS) capable of imaging both thigh and calf veins and that also stratified results by thigh and calf location. Thigh specificity and NPV were calculated classifying calf DVT patients as free of disease. Results: The six studies included 81–214 participants and provided 26 comparisons of 16 different d-dimer assays to the GS. Thigh sensitivity was higher than overall sensitivity in 22 of 26 comparisons (range, −0.3 to 8.6); thigh specificity was lower than overall specificity in all comparisons (range, −0.7 to −7.8); and thigh NPV was higher than overall NPV in 22 of 26 comparisons and unchanged in 4 comparisons (range, 0.0–9.2). NPV was >95% in 20 of the thigh results but >95% in only 8 of the overall results. Conclusions: Different GS can produce clinically significant differences in test indices. Care must be taken in interpreting DVT studies that evaluate d-dimer as a rule-out test and that use US as a GS, because missed calf DVT can falsely increase the NPV.

scholarly journals Novel Biomarkers Associated with Deep Venous Thrombosis: A Comprehensive Review

2008 ◽  
Vol 3 ◽  
pp. 117727190800300 ◽  
Author(s):  
Dawn M Barnes ◽  
Thomas W Wakefield ◽  
John E Rectenwald
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Duplex Ultrasound ◽  
Interleukin 10 ◽  
Serum Marker ◽  
Specific Objective ◽  
Venous Thromboembolic ◽  
Novel Biomarkers ◽  
D Dimer

Primary and recurrent venous thromboembolic disease (VTE, deep venous thrombosis and pulmonary embolism) remain a significant source of morbidity and mortality in the hospitalized patient. Non-specific subjective complaints and lack of specific objective findings related to acute deep venous thrombosis (DVT) and pulmonary embolism (PE) complicate the diagnosis. There remains no single serum marker available to exclusively confirm the diagnosis of VTE. While D-dimer is highly sensitive and useful for diagnostic exclusion, it lacks the specificity necessary for diagnostic confirmation resulting in the need for a variety of additional studies (i.e.: duplex ultrasound, venography, V/Q scanning, helical thoracic and pelvic CT scans and pulmoary angiography). There is evolving research supporting the utility of various plasma markers as novel “biomarkers” for VTE including selectins, microparticles, interleukin-10 and other cytokines. This review attempts to examine recent literature assessing the utility of P-selectin, microparticles, D-dimer, E-selectin, thrombin, interleukins and fibrin monomers in the diagnosis and guidance of therapy for VTE.

The cost–effectiveness of point-of-care D-dimer tests compared with a laboratory test to rule out deep venous thrombosis in primary care

2014 ◽  
Vol 15 (1) ◽  
pp. 125-136 ◽  
Author(s):  
Janneke MT Hendriksen ◽  
Geert-Jan Geersing ◽  
Suzanne C van Voorthuizen ◽  
Ruud Oudega ◽  
Arina J ten Cate-Hoek ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Laboratory Test ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Point Of Care ◽  
The Cost ◽  
D Dimer ◽  
Rule Out

Comparative Effects Of Tissular Urokinase And Urinary Urokinase In The Treatment Of 30 Patients With Pulmonary Embolism And Deep Venous Thrombosis

1981 ◽  
Author(s):  
M F Lorient-Roudaut ◽  
C Vergnes ◽  
J Bonnet ◽  
M R Boisseau ◽  
H Bricaud
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Biological Effects ◽  
Clinical Situation ◽  
Point Of View ◽  
Biological Study ◽  
Serial Determination ◽  
Before And After ◽  
D Dimer

Two types of Urokinase are actually available for the clinical use : tissular urokinase (tUK), isolated from cell culture and urinary urokinase (uUK), partially purified from human urine. Their clinical and biological effects have to be compared.In this study 30 patients with acute pulmonary embolism and/or deep venous thrombosis were treated, using tUK or uUK, 4500 units/kg, during 12 hours.In the clinical field pulmonary angiographies, scintigrams, and phlebographies were obtained before and after the treatment. The biological study was first established on serial determination of fibrinogen, platelets, Quick Time, FDP using two methods and euglo- biiin lysis time. At the end of the treatment plasmatic samples of each patients were studied by immunoprecipitations followed by polyacrylamid gel electrophoresis, in the view of evaluation of the D dimer E complex. Two methods were used (LANE D.A. and al., 1977and WHITAKER A.N. and al, 1980).The results showed a quick similar improvement of the clinical situation. In return tUK appeared to be more effective on the biological point of view. Significant differences were found in : decrease of fibrinogen, increase of FDP and the presence of D dimer fragments. The better action of tUK, especially on the fibrin depositions, is so far unexplained.

Pulmonary embolism secondary to deep venous thrombosis: A retrospective and observational study for clinical characteristics and risk stratification

2021 ◽  
pp. 026835552199096
Author(s):  
Xiaoying Chen ◽  
Xian Liu ◽  
Jinglun Liu ◽  
Dan Zhang
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Scoring System ◽  
Previous History ◽  
Previous Surgery ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
D Dimer

Objective To investigate the risk factors, predilection sites in pulmonary embolism (PE) patients caused by deep venous thrombosis (DVT) and explore the value of scoring systems in assessing the risk of PE in DVT patients. Methods A total of 692 DVT patients were enrolled, and divided into no pulmonary embolism (NPE, 226, 32.66%), silent pulmonary embolism (SPE, 330, 47.67%) and featuring pulmonary embolism (FPE, 136, 19.65%) groups. For each group, the differences of clinical data and PE locations were compared, and the risk factors of PE secondary to DVT were analyzed. The predictive value of the scoring system for the diagnosis of PE and FPE was evaluated. Results PE presented more in the bilateral pulmonary arteries (PAs) (249, 53.43%) and has no significant difference in PESI scores in different locations. Gender, DVT locations, and previous surgery were the independent risk factors of PE. DVT locations, previous history of COPD, and previous surgical interventions were the independent risk factors of FPE. The results for areas under the ROC curves were: AUC(Wells) = 0.675, AUC (Revised Geneva) = 0.601, AUC(D-dimer) = 0.595 in the PE group; AUC(Wells) = 0.722, AUC (Revised Geneva) = 0.643, AUC(D-dimer) = 0.557 in the FPE group. Conclusions PE secondary to DVT mostly occurs in the bilateral PAs. Male gender, DVT locations, and previous surgery increased the risk of PE. The Wells scoring system was more advantageous for evaluating the diagnosis of PE in patients with DVT.

DIAGNOSTIC VALUE OF D-DIMER, FIBRINOGEN DEGRADATION PRODUCTS, ETHANOL GEL TEST AND TRANSFER TEST IN DEEP VENOUS THROMBOSIS AND PULMONARY EMBOLISM

1987 ◽  
Author(s):  
D Wachel ◽  
M Segers ◽  
P Leautaud ◽  
J J Rodzynek
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Transfer Test ◽  
Degradation Products ◽  
Diagnostic Value ◽  
Predictive Values ◽  
Thrombotic Disease ◽  
Emergency Situations ◽  
D Dimer

In order to determine the sensitivity and the specificity of laboratory tests in the diagnosis of thrombotic disease, D-Dimer (D-D) latex, Fibrin(ogen) Degradation Products (FDP), Ethanol Gel Test (EGT) and Transfer Test (TT) were performed in two groups of patients : group 1 = 199 consecutive patients without thrombotic disease, group 2 = 56 patients with thrombosis (Deep Venous Thrombosis confirmed by radiological phlebography, n=19, and Pulmonary Embolism confirmed by ventilation-perfusion lung scintigraphy, n=37). The sensitivity, the specificity, the positive and negative predictive values (PV+ and PV-) for the different tests appeared as follows :Conclusion :1) Among the different parameters which have been studied, D-Dimer latex appears to be the most useful in the clinical practice (sensitivity 98% and specificity 90%).2) Easy to perform, cheap, the results can be obtained within 20 minutes (for instance during the night in emergency situations).

Sign in / Sign up

Export Citation Format

Share Document