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Thrombosis Journal

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01-12-2020 | Postthrombotic Syndrome | Research

Prevalence of venous obstructions in (recurrent) venous thromboembolism: a case-control study

Authors: Pascale Notten, Rob H. W. Strijkers, Irwin Toonder, Hugo ten Cate, Arina J. ten Cate-Hoek

Published in: Thrombosis Journal | Issue 1/2020

Abstract

Background

The role of venous obstructions as a risk factor for recurrent venous thromboembolism has never been evaluated. This study aimed to determine whether there is a difference in prevalence of venous obstructions between patients with and without recurrent venous thromboembolism. Furthermore, its influence on the development of post-thrombotic syndrome and patient-reported quality of life was assessed.

Methods

This matched nested case-control study included 32 patients with recurrent venous thromboembolism (26 recurrent deep-vein thrombosis and 6 pulmonary embolism) from an existing prospective cohort of deep-vein thrombosis patients and compared them to 24 age and sex matched deep-vein thrombosis patients without recurrent venous thromboembolism. All participants received standard post-thrombotic management and underwent an additional extensive duplex ultrasonography. Post-thrombotic syndrome was assessed by the Villalta-scale and quality of life was measured using the SF36v2 and VEINES-QOL/Sym-questionnaires.

Results

Venous obstruction was found in 6 patients (18.8%) with recurrent venous thromboembolism compared to 5 patients (20.8%) without recurrent venous thromboembolism (Odds ratio 0.88, 95%CI 0.23–3.30, p = 1.000). After a median follow-up of 60.0 months (IQR 41.3–103.5) the mean Villalta-score was 5.55 ± 3.02 versus 5.26 ± 2.63 (p = 0.909) and post-thrombotic syndrome developed in 20 (62.5%) versus 14 (58.3%) patients, respectively (Odds ratio 1.19, 95%CI 0.40–3.51, p = 0.752). If venous obstruction was present, it was mainly located in the common iliac vein (n = 7, 63.6%). In patients with an objectified venous obstruction the mean Villalta-score was 5.11 ± 2.80 versus 5.49 ± 2.87 in patients without venous obstruction (p = 0.639). Post-thrombotic syndrome developed in 6 (54.5%) versus 28 (62.2%) patients, respectively (Odds ratio 1.37, 95%CI 0.36–5.20, p = 0.736). No significant differences were seen regarding patient-reported quality of life between either groups.

Conclusions

In this exploratory case-control study patients with recurrent venous thromboembolism did not have a higher prevalence of venous obstruction compared to patients without recurrent venous thromboembolism. The presence of recurrent venous thromboembolism or venous obstruction had no impact on the development of post-thrombotic syndrome or the patient-reported quality of life.

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Title: Prevalence of venous obstructions in (recurrent) venous thromboembolism: a case-control study
Authors: Pascale Notten
Rob H. W. Strijkers
Irwin Toonder
Hugo ten Cate
Arina J. ten Cate-Hoek
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Postthrombotic Syndrome
Thrombosis
Published in: Thrombosis Journal / Issue 1/2020
Electronic ISSN: 1477-9560
DOI: https://doi.org/10.1186/s12959-020-00238-7

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