Clinical studyDoes the location of thrombosis determine the risk of disease recurrence in patients with proximal deep vein thrombosis?∗☆,
Section snippets
Subjects
The study population consisted of 1,149 consecutive patients with symptomatic, lower limb, deep vein thrombosis. In all patients, deep vein thrombosis was confirmed by Duplex ultrasound or venography. Proximal vein thrombosis was classified into one of three categories according to the most proximal vein segment involved. The three categories were popliteal (popliteal vein only), femoral (superficial or common femoral veins), or iliofemoral (iliac and femoral veins). All patients received
Results
Of 1,149 patients with symptomatic proximal deep vein thrombosis, 453 (39.4%) had popliteal vein thrombosis, 645 (56.1%) had femoral vein thrombosis, and 51 (4.4%) had iliofemoral vein thrombosis. The baseline clinical characteristics of the study population are presented in Table 1. The mean age of the study population was 60.3 years (SD = 16.7 years), of whom 633 (55%) were men and 516 (45%) were women. In terms of risk factors for recurrent venous thromboembolism in these 1,149 patients, 239
Discussion
In this analysis of a large patient population with symptomatic proximal vein thrombosis, the location of thrombosis was a predictor of disease recurrence during the initial 3 months of anticoagulant therapy. Patients with iliofemoral vein thrombosis had a greater than twofold higher rate of recurrence than patients with thrombosis that was limited to the femoral or popliteal veins (i.e., 11.8% vs. 5.2%). Although this difference did not reach conventional statistical significance in the
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Dr. Douketis is the recipient of a research scholarship from the Heart and Stroke Foundation of Ontario, Dr. Crowther is the recipient of a research scholarship from the Canadian Institutes of Health Research, and Dr. Ginsberg is the recipient of a Career Investigator Award from the Heart and Stroke Foundation of Ontario.
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