Presence and degree of residual venous obstruction on serial duplex imaging is associated with increased risk of recurrence and progression of infrainguinal lower extremity deep venous thrombosis

Yoo, Taehwan; Aggarwal, Rishav; Wang, Tzu‐Fei; Satiani, Bhagwan; Haurani, Mounir J.

doi:10.1016/j.jvsv.2017.12.059

Cited by 24 publications

(9 citation statements)

References 9 publications

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“…The goal was to reduce the clot burden as much as possible in order to improve long-term outcomes. 12 Most techniques rely on the use of thrombolytic agents, either through systemic or catheter-directed infusion. 13 In the CaVenT study, a 14.5% decrease in the incidence of PTS at 24 months in patients with acute iliofemoral DVT who received CDT treatment compared with those who received anticoagulation treatment was observed.…”

Section: Discussionmentioning

confidence: 99%

Challenging Management of a Patient With Severe Bilateral Deep Vein Thrombosis

Hamandi

Lanfear

Woolbert

et al. 2020

Journal of Investigative Medicine High Impact Case Reports

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Section: Discussionmentioning

confidence: 99%

Challenging Management of a Patient With Severe Bilateral Deep Vein Thrombosis

Hamandi

Lanfear

Woolbert

et al. 2020

Journal of Investigative Medicine High Impact Case Reports

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“…RVT after DVT was repeatedly associated with recurrent venous thromboembolism (VTE) (HR 2.2 and 2.4; OR 3.9 and 21.3). 2,[6][7][8] The presence of RVT after DVT was predictive of developing PTS (OR 2.17) and patients with RVT suffered more severe PTS symptoms (mean Villalta PTS severity score 7.1 versus 2.2). 3,9,10 One recent study identified RVT as the single most powerful predictor of venous stent failure (HR 7.4).…”

Section: Open Vein Hypothesismentioning

confidence: 99%

“…Collecting such enduring data dropped the already low number needed to treat from seven to four. 12 As qualification of PTS for these patients, 83.8% of cases in the CDT arm and 77.8% of the cases in the standard treatment arm were mild (Villalta score [5][6][7][8][9]. Differences in quality of life (QOL) indices measured did not reach statistical significance.…”

Section: Caventmentioning

confidence: 99%

The Importance of Early Thrombus Removal

Cottrell

Silver

2022

Vascular and Endovascular Review

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Historically, anticoagulation has been the primary treatment for acute lower extremity deep venous thrombosis (DVT) with or without thrombolysis. Despite large amounts of clinical research data supporting an ‘open vein hypothesis’, which favours early thrombus removal, clinicians have been hesitant to take this option due to a historically high risk of major bleeding and a few notable studies that failed to show any meaningful benefit. The ATTRACT trial failed to show the benefit of using pharmacomechanical catheter-directed thrombolysis (PCDT) for iliofemoral and femoropopliteal DVT but did result in more bleeding. However, the CaVent study before it revealed a significant reduction in post-thrombotic syndrome (PTS) for patients with iliofemoral and femoral DVT after long-term follow-up past 24 months that grew over time. Since these trials, there have been significant advancements in magnetic resonance and CT venography, intravascular ultrasound (IVUS), venous stenting and thrombectomy catheters meaning there is little to no need for adjunct thrombolytics. Results from ongoing research such as CLEAR-DVT reflect the advances in modern technology.

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“…[46][47][48][49] Residual venous obstruction in patients with treated unprovoked DVT was an overall weak predictor for recurrence according to metaanalysis data, 47,50 while results from studies in specific subsets of patients have shown an increased risk of recurrence. 40,[51][52][53] In addition to the varying use of reference examinations in clinical practice, there is no consensus for the use of residual vein obstruction measurements in predicting recurrence or a standardized methodology for the measurements. 19,22,54 In current guidelines, venography and computed tomography (CT) venography are only suggested if CUS is unavailable or results are inadequate.…”

Section: Imaging Techniquesmentioning

confidence: 99%

How to Differentiate Recurrent Deep Vein Thrombosis from Postthrombotic Syndrome

2020

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Venous thromboembolism (VTE) is associated with significant morbidity and mortality. Accuracy of diagnosis is thus of vital importance. Failure to diagnose VTE increases the risk of progression and complications. Conversely, anticoagulation as a result of an incorrect diagnosis exposes patients to the associated hazards of bleeding. The diagnostic management of recurrent deep vein thrombosis (DVT) and postthrombotic syndrome (PTS) is especially challenging due to the lack of well-established diagnostic standards. Particularly, the differentiation between the two is notoriously difficult as symptoms, clinical signs, and diagnostic test findings largely overlap. This review highlights the current diagnostic and management strategies for recurrent DVT and PTS with a focus on clinical findings and imaging modalities. We also discuss current open questions for clinicians in the field, anticipating future directions and predictions for the year 2050.

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Presence and degree of residual venous obstruction on serial duplex imaging is associated with increased risk of recurrence and progression of infrainguinal lower extremity deep venous thrombosis

Cited by 24 publications

References 9 publications

Challenging Management of a Patient With Severe Bilateral Deep Vein Thrombosis

Challenging Management of a Patient With Severe Bilateral Deep Vein Thrombosis

The Importance of Early Thrombus Removal

How to Differentiate Recurrent Deep Vein Thrombosis from Postthrombotic Syndrome

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