Risk of Recurrence After a First Episode of Symptomatic Venous Thromboembolism Provoked by a Transient Risk Factor

Abstract

The risk of recurrence is low if VTE is provoked by surgery, intermediate if provoked by a nonsurgical risk factor, and high if unprovoked. These risks affect whether patients with VTE should undergo short-term vs indefinite treatment.

Deep vein thrombosis in a transgender woman

“…1 The risk is highest for unprovoked VTE, intermediate from a nonsurgical risk factor (estrogen therapy, pregnancy, flights longer than 8 h, leg injury) and low if VTE is provoked by surgery (Box 1). 3,4 …”

Managing pulmonary embolism using prognostic models: future concepts for primary care

“…Long-term prognosis differs for patients with provoked (e.g., by a transient risk factor such as recent surgery) or an unprovoked (i.e., idiopathic or spontaneous) pulmonary embolism. A recent metaanalysis 26 showed that patients with a provoked event (defined by the authors as being related to recent surgery, immobilization, puerperium, estrogen use, major trauma or medical illness have a low risk of recurrence. The risk of recurrence has been reported to be less than 1% for provoked pulmonary embolism caused by surgical factors and about 4% for those caused by nonsurgical factors (e.g., medical illness or immobilization).…”

“…The risk of recurrence has been reported to be less than 1% for provoked pulmonary embolism caused by surgical factors and about 4% for those caused by nonsurgical factors (e.g., medical illness or immobilization). 26 In contrast, patients with an unprovoked pulmonary embolism generally have a higher risk of recurrence than patients with provoked pulmonary embolism. 27 However, this group of patients is heterogeneous and can range, for example, from a woman with a first pulmonary embolism at age 34 years to a man with a first episode at 71 years.…”

Diagnosis and treatment of DVT and prevention of DVT recurrence and the PTS: bridging the gap between DVT and PTS in the primary care setting or outpatient ward

“…Michiels et al 49 have already started a pilot study to test the feasibility of planning a multicenter prospective management and safety outcome study, according to the proposed concept shown in Figure 6, in the primary care setting. PTS is a chronic condition that affects the deep venous system, and it may extend to the superficial venous system of the legs in patients with a documented history of DVT, as discussed in our clinical review on bridging the gap between DVT and the PTS by Michiels et al 49 According to Iorio et al,50 in 2010, the acceptable expected rate of recurrent VTE after the discontinuation of anticoagulation in post-DVT patients with a first unprovoked DVT was ,4% in the first year and ,6.7% after 2 years with the In most cases, puncture of the popliteal vein is used to access the deep venous system. Venous ulcers are treated according to modern evidence-based guidelines.…”