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[Value of the plasma measurement of D-dimers in the diagnosis of venous thromboembolism].

Plasma measurement of D-dimers (DD), which are fibrin-specific degradation products, progressively replaces the cumbersome dosage of fibrinogen degradation products (FDP's) in serum for diagnosis and follow-up of consumption coagulopathies, for diagnosis of prethrombotic states and, potentially, for the control of the efficacy of antithrombotic therapies. Moreover, when the ELISA technique is used, this measurement may be very useful in the diagnosis approach of venous thromboembolic disease. In the present review, data are presented which strongly support the view that a low level of plasma D-dimers (less than 500 micrograms/L when using the ELISA from Stago) allows to exclude the diagnosis of deep venous thrombosis or pulmonary embolism with predictive values of 94 % and 100 % respectively. It is suggested that such a diagnostic potential might be very useful in the group of patients with inconclusive perfusion-ventilation scintigraphy (low or indeterminate probability of pulmonary embolism) which represent about 50 % of the patients with suspected pulmonary embolism.