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Circulation, Vol 64, 622-625, Copyright © 1981 by American Heart Association
R Hull, J Hirsh, DL Sackett, DW Taylor, C Carter, AG Turpie, P Powers and M Gent
Although it is generally accepted that negative venography excludes deep
vein thrombosis (DVT) in patients in whom it is clinically suspected, there
is no evidence to support this conclusion. To test the correctness of
withholding anticoagulant therapy in these patients, we followed 160
consecutive patients who had clinically suspected DVT and negative
venograms to determine the frequency of postvenographic DVT. Anticoagulant
therapy was withheld in all patients. No patient died or developed
pulmonary embolism during 3 months of follow-up. Two of the 160 patients
(1.3%) attended the clinic on an emergency basis during follow-up with new
symptoms of DVT and in both patients, DVT was confirmed by objective
testing. These events developed within 5 days of venography, which suggests
that they were induced by venography. Nevertheless, the findings indicate
it is safe to withhold treatment in patients with clinically suspected DVT
and negative venograms.
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Clinical validity of a negative venogram in patients with clinically suspected venous thrombosis
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