Screening for Occult Malignancy in Patients With Idiopathic Venous Thromboembolism

Inclusion Criteria

• •Patients with a new diagnosis of unprovoked proximal deep vein thrombosis (DVT) or pulmonary embolism (PE) will be eligible to participate into the study:
• •* Unprovoked VTE is defined as the absence of any of the following predisposing factors:
• •1. known active cancer;
• •2. recent (less than 3 months) paralysis, paresis or plaster immobilization of the lower extremities;
• •3. recently bedridden for period of 3 or more days, or major surgery, within the previous 12 weeks requiring general or regional anaesthesia;
• •4. previous unprovoked VTE;
• •5. known thrombophilia (hereditary or acquired)
• •* Proximal DVT is defined as a non-compressibility of any vein segment from the common femoral vein to the trifurcation of the popliteal vein or a persistent intra-luminal filling defect of the iliac, common femoral, superficial femoral or popliteal veins on contrast venography.
• •* Pulmonary embolism is defined as:
• •1. patients with a high/intermediate pre-test probability (Wells' model \> 4) + high probability V/Q scan;
• •2. positive pulmonary angiogram; or
• •3. spiral CT demonstrating intraluminal filling defect in a vessel larger than a segmental artery