Popliteal vein thrombosis after a flight. Part 2

If no thrombus is seen in the popliteal vein on ultrasonography one month after the event, is it possible it may have travelled to the pulmonary artery?

Jeffrey Weitz: What you are getting at is if you see resolution of the thrombus in patient’s popliteal vein, you are hypothesizing that the thrombus is now in his lung. I do not necessarily think that that is the case. It is true that if you look very carefully for pulmonary embolism (PE) in patients with proximal deep vein thrombosis (DVT) at the time of diagnosis, you can find PE in up to 50% of patients.

The point is the patient has not had, from what you are telling me, any symptomatic PE. It is also possible that this thrombus has just resolved in situ and that is why it is better. I would not use the fact that his ultrasound is now normalized as an indication to treat him for longer or think that he is at any higher risk.