What is the role of D-dimer testing in the workup of deep venous thrombosis (DVT)?

Updated: Jun 06, 2019
  • Author: Kaushal (Kevin) Patel, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

D-dimers are degradation products of cross-linked fibrin by plasmin that are detected by diagnostic assays. D-dimer level may be elevated in any medical condition where clots form. D-dimer level is elevated in trauma, recent surgery, hemorrhage, cancer, and sepsis. [104] Many of these conditions are associated with higher risk for deep venous thrombosis (DVT).

D-dimer levels remain elevated in DVT for about 7 days. Patients presenting late in the course, after clot organization and adherence have occurred, may have low levels of D-dimer. Similarly, patients with isolated calf vein DVT may have a small clot burden and low levels of D-dimer that are below the analytic cutoff value of the assay. This accounts for the reduced sensitivity of the D-dimer assay in the setting of confirmed DVT.


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