CONTEXTO: Sintomas e sinais clínicos indicativos de trombose venosa profunda (TVP) são comuns mas podem ter inúmeras causas. OBJETIVOS: 1) Identificar os sintomas mais frequentes e correlacioná-los com achados de dúplex scan (DS); 2) identificar condições clínicas de alto risco para TVP; e 3) avaliar o intervalo de tempo decorrido entre o início dos sintomas e o exame do paciente. MÉTODOS: Um total de 528 pacientes com suspeita clínica de TVP foram examinadosvia DS por ultrassonografistas vasculares experientes. RESULTADOS: TVP esteve presente em 192 (36,4%) dos pacientes analisados. A veia ilíaca externa esteve acometida em 53 pacientes (10,04%), as veias femorais em 110 (20,83%), a veia poplítea em 124 (23,48%), e as veias abaixo do joelho em 157 casos (29,73%). Edema de membro esteve presente em 359 casos (68%), e 303 (57,4%) se queixaram de dor. Sessenta e nove pacientes realizaram DS devido a embolia pulmonar (EP) suspeita ou comprovada; 79 pacientes estavam em período pós-operatório. Na análise multivariada, os fatores de risco independentes para TVP incluíram idade >65 anos [OR=1,49; intervalo de confiança de 95% (IC95%) 1,01-2,18; p=0,042], edema (OR=2,83; IC95% 1,72-4,65; p<0,001), dor (OR=1,99; IC95% 1,3-3,05; p=0,002), câncer (OR=2,32; IC95% 1,45-3,72; p<0,001) e EP (OR=2,62; IC95% 1,29-5,32; p=0,008). O tempo decorrido desde o início dos sintomas foi semelhante nos dois grupos. CONCLUSÕES: No presente estudo, 36,4% dos pacientes encaminhados para DS apresentaram TVP. Idade acima de 65 anos, presença de edema de membro, dor, câncer e EP suspeita ou comprovada devem ser considerados fatores de risco maiores para TVP.

BACKGROUND: Symptoms and clinical signs suggestive of deep vein thrombosis (DVT) are common but may have numerous possible causes. OBJECTIVES: 1) To identify the most frequent clinical symptoms and correlate them with duplex ultrasound scan (DS) findings; 2) to identify high-risk clinical conditions for DVT; and 3) to evaluate time since the onset of symptoms and DS examination. METHODS: A total of 528 patients with a clinical suspicion of DVT were evaluated by DS performed by experienced vascular ultrasonographists. RESULTS: DVT was present in 192 (36.4%) of the patients. The external iliac vein was involved in 53 patients (10.04%), the femoral veins in 110 (20.83%), the popliteal vein in 124 (23.48%), and veins below the knee were involved in 157 (29.73%) of the cases. Limb swelling was present in 359 cases (68%), and 303 (57.4%) complained of pain. Sixty nine patients received a DS due to suspected or proven pulmonary embolism (PE); 79 patients were in postoperative period. In the multivariate analysis, independent risk factors for DVT included age>65 years (OR=1.49; 95% confidence interval [95%CI] 1.01-2.18; p=0.042), edema (OR=2.83; 95%CI 1.72-4.65; p<0.001), pain (OR=1.99; 95%CI 1.3-3.05; p=0.002), cancer (OR=2.32; 95%CI 1.45-3.72; p<0.001), and PE (OR=2.62; 95%CI 1.29-5.32; p=0.008).Time since the onset of symptoms did not differ between the groups. CONCLUSIONS: In the present study, 36.4% of the patients referred to DS had DVT. Age > 65 years, presence of limb swelling, pain, cancer, and suspected or proven PE should be considered as major risk factors for DVT.

BACKGROUND: Diagnosis of abdominal aortic aneurysm (AAA) is usually incidental, and surgical treatment, when indicated, may be open or endovascular. The drawbacks of computed angiotomography (CTA) and the advantages of Doppler ultrasonography have led to the development of alternative follow-up protocols, comparing the two methods. OBJECTIVE: To determine validity indices for Doppler ultrasonography and to correlate them with CTA results in a group of patients who had undergone elective endovascular treatment of AAAs. MATERIAL AND METHODS: Thirty-three patients were selected. The following three items were evaluated: 1) presence or absence of endoleak; 2) presence of blood flow in the aortoiliac segment; and 3) maximum AAA diameter. RESULTS: For the detection of endoleak, Doppler ultrasonography showed a sensitivity of 54.5%, a specificity of 92.8%, a positive predictive value of 85.7%, a negative predictive value of 92.8%, and an overall accuracy of 76%. For the evaluation of blood flow in the aortoiliac segment, values were 100, 97.8, 80, 97.8, and 98%, respectively. Maximum AAA diameter was similarly measured by both methods, with statistically significant differences (mean difference: 1.98 mm). Pearson's correlation coefficient was 0.97, showing that Doppler ultrasonography and CTA yielded similar results. CONCLUSION: Doppler ultrasonography showed good validity indices and a moderate correlation with CTA in the postoperative evaluation of patients undergoing endovascular treatment of AAAs.

OBJETIVO: Determinar a prevalência de refluxo venoso na veia safena parva em membros inferiores com varizes primárias não complicadas pelo eco-Doppler colorido. MÉTODO: No período de 18 meses, 1.953 pacientes foram submetidos ao eco-Doppler colorido de membros inferiores por doença venosa. Destes, 1.631 com varizes primárias não complicadas foram selecionados para esta análise, sendo que 1.383 eram do sexo feminino (84,79%) e 248 (15,21%) do sexo masculino. A média de idade dos pacientes foi de 42,89 (± 0,48) anos, variando de 13 a 85 anos. Dos 1.631 pacientes, 1.323 foram submetidos a exame bilateral e 308 a exame unilateral, totalizando 2.954 membros inferiores com varizes primárias não complicadas avaliados. Desse total, 1.461 eram membros inferiores direitos e 1.493, esquerdos. Todos os exames foram realizados seguindo o mesmo protocolo. RESULTADO: Dos 2.954 membros inferiores avaliados, 372 (12,59%) apresentaram refluxo em veia safena parva. A prevalência nos homens foi de 14,08% e, nas mulheres, de 12,35%. O refluxo da safena parva foi maior no membro inferior esquerdo (13.13%) do que no direito (12,05%). A prevalência do refluxo foi significativamente maior nos pacientes acima de 60 anos. CONCLUSÃO: O refluxo da veia safena parva é relativamente comum, e sua pesquisa deve ser sempre realizada em pacientes com varizes primárias de membros inferiores.

OBJECTIVE: To determine the prevalence of small saphenous vein reflux (SSVR) in patients with uncomplicated varicose veins, using color-flow Doppler ultrasonography. METHOD: Over an 18-month period, a total of 1,953 patients underwent color-flow Doppler ultrasonography for evaluation of venous disease. Out of the total, 1,631 patients with primary uncomplicated varicose veins were selected for this study: 1,383 (84.79%) patients were female and 248 (15.21%) were male. Mean age was 42.9 (± 0.48) years, ranging from 13 to 85 years. Of the 1,631 patients, 1,323 underwent bilateral examination and 308 unilateral examination, for a total of 2,954 lower limbs with primary uncomplicated varicose veins studied. The number of right lower limbs studied was 1,461 and the number of left lower limbs was 1,493. All exams were carried out using the same protocol. RESULT: Out of the total number of 2,954 limbs, SSVR was detected 372 (12.59%) limbs. Prevalence of SSVR in males was 14.08% and in females was 12.35%. SSVR was detected in the right lower limb in 12.05% and in left lower limb in 13.13% of the cases. SSVR was significantly more common in patients older than 60 years. CONCLUSION: SSVR is relatively common and its presence should always be investigated in patients with primary lower limb varicose veins.