Yale: Ultrasound is the most common technique for detecting a widespread
cardiovascular condition: blood clots in the leg, otherwise known as
deep vein thrombosis (DVT). But there’s a little known — yet serious —
risk to using ultrasound to diagnose DVT, say Yale researchers in a new
study published this week by Seminars in Thrombosis and Hemostasis.
Principal
investigator and senior author Dr. Behnood Bikdeli and his colleagues
suspected that the pressure from an ultrasound exam could cause a clot
to break off and travel to the lungs where it could form a potentially
fatal blockage, or embolism. To determine the extent of this deadly
complication, the researchers conducted an exhaustive and highly
sensitive review of more than 3,600 published articles. They not only
found cases of pulmonary embolism resulting from ultrasound for DVT, but
several separate reports that claimed to be the first to see the
connection. While rare, it is an “under-recognized and underreported
condition,” said Bikdeli.
Ultrasound is still the safest method of
diagnosing DVT, but the study authors concluded that both clinicians
and radiologists need to be more aware of the phenomenon and take
precautions. For example, if a patient has a large clot or becomes short
of breath after an exam, clinicians should check for the complication.
“Be mindful of it,” he noted. “Otherwise, it can lead to a fatal event.”
Additionally,
“our study also signifies the importance of the search strategy,” said
Bikdeli. “A prior systematic review had erroneously claimed that no
reports existed about this phenomenon. Clinicians and researchers who
look for uncommon or rare clinical events should either develop advanced
skills for highly sensitive searching or collaborate with medical
librarians who have the expertise of building sophisticated search
queries for such purposes.”