Related Experiment Videos
Extent of thrombus evaluated in patients with recurrent and first deep vein thrombosis
Astrid M Fink1, Wolfgang Mayer, Andreas Steiner
1Department of Dermatology, Wilhelminen Hospital, Vienna, Austria. finka@a1.net
Insights
Patients with recurrent deep vein thrombosis (DVT) more frequently have proximal DVT. However, the risk of pulmonary embolism (PE) is similar for both first and recurrent DVT cases.
Area of Science:
- Vascular Medicine
- Thrombosis Research
- Medical Imaging
Background:
- Deep vein thrombosis (DVT) is a significant vascular condition.
- Understanding thrombus extent is crucial for DVT management.
- Recurrent DVT may present differently than initial DVT.
Purpose of the Study:
- To compare the extent of thrombus in patients experiencing recurrent deep vein thrombosis (DVT) versus those with a first-time DVT.
- To analyze the anatomical distribution of thrombus in DVT patients.
Main Methods:
- Retrospective analysis of 864 patients diagnosed with DVT of the leg.
- Classification of DVT into first-time (n=631) and recurrent (n=233) groups.
- Evaluation of thrombus extent using duplex scanning, contrast venography, or MRI, categorizing as distal or proximal DVT.
Main Results:
- Proximal DVT (CEAP anatomic classification 1-9) was significantly more frequent in patients with recurrent DVT compared to first-time DVT (P <.001).
- The incidence of pulmonary embolism (PE) and its clinical symptoms did not differ significantly between recurrent and first-time DVT groups (P >.05).
- Only one patient in the study sample died due to PE.
Conclusions:
- Recurrent DVT is associated with a higher prevalence of proximal thrombus extension.
- Despite differences in thrombus location, the risk of pulmonary embolism remains comparable between recurrent and first-time DVT.
- These findings highlight the importance of assessing thrombus extent in DVT recurrence.
Objectives:
The objective of this retrospective study was to document the extent of thrombus in patients with recurrent and first deep vein thrombosis (DVT).
Patients And Methods:
A total of 864 patients with DVT of the leg were enrolled in the study. They were divided into two groups: patients with recurrent DVT (n = 233) of the leg, and patients with first DVT of the leg (n = 631). In both groups the extent of the thrombus was evaluated by duplex scanning, contrast venography, or magnetic resonance imaging. Thrombus involving veins distal to the popliteal vein was classified as distal DVT, whereas involvement of the popliteal vein and proximal was classified as proximal DVT.
Results:
We could demonstrate that involvement of proximal segments (CEAP anatomic classification 1-9) occurred significantly more often in patients with recurrent DVT than in patients with the first DVT (P <.001). The incidence of pulmonary embolism (PE) and the clinical symptoms of PE were equally distributed between patients with recurrent DVT and those with first DVT (P >.05). Only one patient died as a consequence of PE in our patient sample.
Conclusions:
In our experience, patients with recurrent DVT have a higher frequency of proximal DVT. Nevertheless, the incidence of PE is similar in patients with recurrent and those with first DVT.