Deep Venous Thrombosis (DVT) in Trauma : A Literature Review

Venography

First Author	Year	Reference Title	Class	Conclusions
Rabinov K	1972	Roentgen diagnosis of venous thrombosis in the leg. Arch Surg 104:134-44	III	This study refined and standardized the technique of venography in the detection of DVT.
Bettman MA	1987	Contrast venography of the leg: Diagnostic efficacy, tolerance, and complication rates with ionic and nonionic contrast material. Radiology 165:113-6	II	Multi-institutional study comparing ionic and non-ionic contrast material for venography. Demonstrated 9% post-venography DVT by 125I-fibrinogen scanning.
Wheeler HB	1995	Diagnostic methods for deep vein thrombosis. Haemostasis 25:6-26	III	Excellent review of current state of the art on the diagnostic modalities to detect DVT. Good discussion of limitations of venography.
Sandler DA	1984	Diagnosis of deep-vein thrombosis: Comparison of clinical evaluation, ultrasound, plethysmography and venoscan with x-ray venogram. Lancet ii:716-9	III	50 patients with suspected DVT underwent numerous diagnostic studies. Least accurate was IPG and most accurate was venogram but this was only 90%.
Burke B	1995	The diagnostic approaches to deep venous thrombosis. Clin Chest Med 16:253-68	II	Review of diagnostic modalities for DVT. Venogram considered "gold standard" to which other modalities are compared.
Geerts WH	1994	A prospective study of venous thromboembolism after major trauma. N Engl J Med 331:1601-6	II	Major incidence study of DVT following trauma in patients who received no prophylaxis. Diagnosis of DVT was made by contrast venography.

Venography

First Author	Year	Reference Title	Class	Conclusions
Kakkar VV	1970	Deep vein thrombosis of the leg. Is there a "high risk" group? Am J Surg 120:527-30	III	Radioactive fibrinogen study that demonstrated a significant number of calf emboli extend proximally.
Brathwaite CE	1993	Complications of anticoagulation for pulmonary embolism in low risk trauma patients. Chest 104:718-20	III	Study demonstrated anticoagulation had a high bleeding complication rate (36%) even in low risk trauma patients.
Kudsk KA	1989	Silent deep vein thrombosis in immobilized multiple trauma patients. Am J Surg 158:515-9	III	Incidence study of DVT employing venogram as diagnostic modality. 63% of immobilized patients for 10 days or longer developed DVT.
Freeark RJ	1967	Posttraumatic venous thrombosis. Arch Surg 95:567-75	II	Early study employing venogram in 124 trauma patients in hospital 3 weeks or longer. 35% incidence of DVT in this population.
Yelnik A	1991	Systematic lower limb phlebography in acute spinal cord injury in 147 patients. Paraplegia 29:253-60	II	Serial venogram revealed a significant rate of DVT in spinal cord injured patients.