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Journal of Ultrasound in Medicine, Vol 10, Issue 9 493-496, Copyright © 1991 by American Institute of Ultrasound in Medicine
Utility of duplex ultrasound in the diagnosis of asymptomatic catheter-induced subclavian vein thrombosis
W. D. Haire, T. G. Lynch, R. P. Lieberman, G. B. Lund and J. A. Edney
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330.
Asymptomatic thrombosis of the subclavian vein is common after placement of
indwelling catheters. The sequelae of these thrombi are not known.
Investigation is hampered by the requirement for venography for diagnosis;
consequently, a noninvasive method of diagnosis would be welcome in this
context. We have studied prospectively 32 subclavian catheters to determine
the usefulness of duplex ultrasound in diagnosing asymptomatic thrombosis.
Sixteen arm venograms were normal and all gave normal duplex scans. No
false-positive scans were obtained. Eleven venograms demonstrated
nonocclusive mural thrombi. Only three of these were seen with duplex
ultrasound. Five totally occlusive thrombi were seen on venography, of
which only two were detected with duplex sonography. The three thrombi not
found with duplex ultrasound were short proximal venous occlusions. The
insensitivity of this technique to asymptomatic subclavian thrombi limits
its usefulness as a screening tool.
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