Ultrasound is the main diagnostic method for deep vein thrombosis. This procedure is valuable to assess spread of thrombotic masses and risk of embolism. In turn, these data affect the treatment of deep vein thrombosis and incidence of venous thromboembolism. To date, data on deep vein thrombosis are retrospectively collected that often does not correspond to actual timing of thrombosis.

OBJECTIVE

To develop the elastography-based classification of thromboses and to correlate these data with timing of thrombosis, duration of thrombolytic treatment and incidence of complications.

MATERIAL AND METHODS

A prospective non-randomized trial included 49 patients with deep vein thrombosis. Upon admission, all patients underwent ultrasound with shear wave elastography. We compared anamnestic data on thrombosis with elastography findings. After that, patients underwent selective thrombolysis with subsequent assessment of treatment outcomes, duration of thrombolysis and incidence of bleedings. These data were interpreted in the context of elastography-based types.

RESULTS

When comparing the anamnestic duration of thrombosis and elastography data, we found significant differences (p= 0.031). Correlation analysis of Young’s modulus and duration of thrombolytic treatment revealed a direct strong relationship (ρ=0.837, p<0.001). The differences in the incidence of hemorrhagic complications in various elastography-based types were significant with their predominance in type III (p=0.0003).

CONCLUSION

Elastographic type I of venous thrombosis requires thrombolytic treatment with elimination of residual obstruction in early period (up to 7 days), type II — thrombolysis with elimination of obstruction in early period after individual assessment of benefit/risk of intervention, type III — conservative treatment with elimination of obstruction in long-term period due to high risk of bleeding and low effectiveness of thrombolytic treatment.