Considerable progress has been made over the last 15 years in our understanding of the natural history, diagnosis, and treatment of deep vein thrombosis.1 The nonspecificity of clinical diagnosis has been confirmed by several studies,2-5 and the reliability of objective tests such as fibrinogen I 125 leg scanning,6 venography,7 and impedance plethysmography (IPG) has been established for patients who present with their first episode of clinically suspected venous thrombosis.8,9 In contrast, relatively few studies have been performed to clarify the diagnostic process in patients with a history of venous thrombosis who have recurrent symptoms of leg pain and swelling.10,11
Until recently, most of these symptomatic patients were considered to have acute recurrent deep vein thrombosis (which is potentially life-threatening) on the basis of their clinical presentation alone. They then received long-term anticoagulant therapy or, in some cases, caval interruption procedures. Some patients experienced the inconvenience of multiple hospital admissions or
Leclerc JR, Jay RM, Hull RD, Hirsh J. Recurrent Leg Symptoms Following Deep Vein ThrombosisA Diagnostic Challenge. Arch Intern Med. 1985;145(10):1867–1869. doi:10.1001/archinte.1985.00360100133022
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