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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
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Isolated distal deep vein thrombosis: What have we learnt from the OPTIMEV study?
J-P Galanaud1, M-A Sevestre2, G Pernod3
1Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada.
Journal De Medecine Vasculaire
|April 29, 2023
Summary
The OPTIMEV study reveals distal deep vein thrombosis (DVT) is a common venous thromboembolic disease (VTE) presentation. Distal DVT shares risk factors with proximal DVT but has a lower recurrence rate after treatment cessation, especially in non-cancer patients.
Area of Science:
- Vascular Medicine
- Thrombosis Research
- Clinical Epidemiology
Background:
- The clinical significance of isolated distal deep vein thrombosis (DVT) has been debated.
- Optimal management strategies for distal DVT remain under investigation.
Purpose of the Study:
- To provide innovative insights into the risk factors, management, and outcomes of distal DVT.
- To clarify the relationship between distal and proximal deep vein thrombosis within the spectrum of venous thromboembolic disease (VTE).
Main Methods:
- Analysis of 6 articles published between 2009 and 2022.
- Inclusion of 933 patients with distal DVT.
- Systematic screening of lower extremity deep veins for DVT suspicion.
Main Results:
- Distal DVT is the most frequent VTE presentation when distal veins are systematically screened, even with oral contraceptive use.
- Distal and proximal DVTs are clinical manifestations of the same VTE disease, sharing risk factors but differing in the type of risk factor prevalence (transient vs. permanent).
- Distal DVT, including calf and muscular DVTs, have similar prognoses and risk factors to proximal DVT, with a lower recurrence rate (half that of proximal DVT) after anticoagulation cessation in non-cancer patients.
Conclusions:
- Distal DVT is a significant clinical entity within VTE.
- Distal DVT management should consider its shared pathophysiology with proximal DVT but distinct recurrence patterns.
- Cancer patients with distal DVT have similar outcomes to those with proximal DVT regarding mortality and recurrence.
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