Point-of-care ultrasound (POCUS) for real-time visualization of lower-extremity (LE) deep vein thrombosis (DVT) and venous reflux (VR) was quick, well-accepted by patients, and significantly reduced patient anxiety, according to a new study. However, POCUS missed some abnormalities in patients with a later diagnosis of post-thrombotic syndrome (PTS), and some patients without PTS showed some signs on POCUS.
“LE DVT, the most common form of venous thromboembolism, is associated with serious complications, including risk of embolization, psychological distress with anxiety, and the long-term sequelae of PTS. Despite its clinical impact, PTS remains largely a subjective diagnosis, often using the Villalta Scale, which lacks specificity due to overlap of findings and symptoms with other conditions,” wrote the authors, led by Tro Sekayan of the Department of Medicine, Division of Hematology/Oncology at the University of California, San Diego.
They sought to assess the utility of POCUS, a real-time, noninvasive diagnostic modality used across a variety of medical specialties. To the authors’ knowledge, it is not widely used in hematology clinics to evaluate DVT and venous reflux, both major contributors to PTS. Their study compared POCUS findings with Villalta Scale scores and evaluated effects on patient anxiety and satisfaction.
They enrolled 101 adult patients (median age of 62.5 years) with a history of LE DVT who were able to independently complete patient-reported outcome questionnaires. Trained hematology fellows conducted a three-point compression ultrasound protocol to assess DVT and VR in affected and unaffected extremities. The test evaluated the common femoral, femoral, and popliteal veins. The team also diagnosed and graded PTS with the Villalta Scale.
POCUS identified persistent DVT in 64% of patients, VR in 48.8%, and PTS in 61.6% (about 60% mild, 23% moderate, and 17% severe). Extremities with DVT were three times more likely to have VR than those without. In this sample, most patients met PTS criteria based on Villalta Scale scores rather than clinical findings, although about 67% of lower extremities without PTS still exhibited abnormalities on POCUS.
According to results on the PROMIS Anxiety Short Form and the Short Assessment of Patient Satisfaction (SAPS), 60.4% of patients had less DVT-related anxiety, and 98% reported being satisfied or very satisfied with their care. This satisfaction was despite longer visit time with POCUS of about nine minutes.
“POCUS seems valuable to solidify the clinical diagnosis of PTS, identify at-risk patients, and enhance patient experience and engagement. Larger longitudinal studies are needed to validate these findings and assess the utility of POCUS-guided management strategy,” the authors concluded.
Reference
Sekayan T, Sun T, von Drygalski A. Point-of-care ultrasound in outpatient hematology clinic: A quick approach to evaluating deep vein thrombosis, venous reflux, and their implications for post-thrombotic syndrome. Abstract abs25-12197. Presented at: the 67th American Society of Hematology Annual Meeting and Exposition, Dec. 6-9, 2025, Orlando, FL.
