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Risk Factors and Anticoagulation Therapy in Patients With Isolated Distal Deep Vein Thrombosis in the Early

Yuping Li1, Junrong Ding1, Lei Shen1

  • 1Department of General Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.

Frontiers in Surgery
|May 17, 2021
PubMed

Insights

Age and postoperative D-dimer levels predict isolated distal deep vein thrombosis (IDDVT) after thoracic surgery. Half-dose anticoagulation is effective and safe for IDDVT treatment, reducing medication needs post-discharge.

Area of Science:

  • Vascular Surgery
  • Thrombosis Research
  • Diagnostic Imaging

Background:

  • Isolated distal deep vein thrombosis (IDDVT) comprises about 50% of deep venous thrombosis (DVT) cases.
  • Current diagnostic and management strategies for IDDVT are not well-defined and remain controversial.
  • Thoracic surgery patients are a key population for DVT risk assessment.

Purpose of the Study:

  • To identify risk factors and predictors of IDDVT in patients undergoing thoracic surgery.
  • To evaluate the efficacy and safety of different anticoagulation therapy strategies for IDDVT.
  • To compare outcomes between full-dose and half-dose anticoagulation regimens.

Main Methods:

  • A cohort of 310 patients undergoing thoracic surgery were assessed using whole-leg ultrasonography and D-dimer level measurements.
  • Clinical data, including pre- and postoperative D-dimer levels and anticoagulant therapy, were collected.
  • Logistic regression analysis was employed to determine independent predictors of postoperative IDDVT.

Main Results:

  • Patients with IDDVT showed significantly higher age and postoperative D-dimer levels compared to the non-DVT group.
  • Postoperative D-dimer level emerged as a significant independent predictor of IDDVT, even after adjusting for age and surgical method.
  • Both full-dose and half-dose anticoagulation regimens demonstrated comparable safety profiles, with no significant adverse effects.
  • Half-dose therapy was associated with a significant reduction in the need for post-discharge anticoagulation medication.

Conclusions:

  • Elevated age and postoperative D-dimer levels are significant predictors of IDDVT following thoracic surgery.
  • Half-dose therapeutic anticoagulation is as effective as full-dose in preventing IDDVT progression.
  • Half-dose anticoagulation presents a safe and potentially more cost-effective treatment option for IDDVT patients post-thoracic surgery.

Keywords:
D-dimerIDDVTanticoagulation therapyrisk factorsthoracic surgery

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