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Title: Retrospective review on isolated distal deep vein thrombosis (IDDVT) - A benign entity or not?
Austin Authors: Ho, Prahlad;Lim, Hui Y;Chua, Chong Chyn ;Sleeman, Matthew ;Tacey, Mark A ;Donnan, Geoffrey A ;Nandurkar, Harshal
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Florey Institute of Neurosciences and Mental Health, Parkville, Victoria, Australia
Australian Centre for Blood Diseases, Prahran, Victoria, Australia
Monash University, Clayton, Victoria, Australia
Northern Health, Epping, Melbourne, Victoria, Australia
University of Melbourne, Parkville, Victoria, Australia
Issue Date: Jun-2016 2016-04-07
Publication information: Thrombosis research 2016; 142: 11-16
Abstract: Isolated distal deep venous thrombosis (IDDVT) is traditionally associated with less severe clinical sequelae, with ongoing debate on multiple aspects of its management. Despite numerous studies evaluating its acute management, there remains a paucity of data evaluating long-term complications such as recurrence and subsequent malignancy. We aim to evaluate the characteristics of IDDVT in institutions that routinely perform whole leg ultrasonography, and the risks of recurrence and complications in comparison to major venous thromboembolism (major VTE; defined as above-knee or proximal DVT and pulmonary embolism (PE)). Retrospective evaluation of consecutive IDDVT and major VTE from July 2011 to December 2012 in a hospital network in Melbourne, Australia. Patients were followed up for a minimum of 24months. Patients with active malignancy were excluded. Of 1024 VTE cases, there were 164 non-cancer patients (92 males, 72 females, median age of 61years) with IDDVT. Compared to major VTE, IDDVT was more likely to be provoked (73% vs 59%, p<0.01), has shorter duration of anticoagulation (median 3.5months vs 6.0months, p<0.01) and less clinically significant bleeding (2.4% vs 6.7%, p=0.05), independent of duration of therapy. Recurrence was non-inferior compared to major VTE (10% vs 7%, p=0.36) and 60% recurred with major VTE. Three (1.8%) were subsequently diagnosed with cancer (vs 1.9% in major VTE, p=0.97). IDDVT has non-inferior rates of recurrence and subsequent cancer detection compared to major VTE and hence, its clinical significance should not differ from major VTE. Further studies are required to determine the adequate length of anticoagulation.
DOI: 10.1016/j.thromres.2016.04.003
ORCID: 0000-0002-2162-3288
PubMed URL: 27093232
Type: Journal Article
Subjects: Bleeding
Deep vein thrombosis
Epidemiological studies
Appears in Collections:Journal articles

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