Risk factors for residual thrombotic occlusion after proximal deep vein thrombosis of the legs.
OBJECTIVE
Residual thrombotic occlusion (RTO) after deep vein thrombosis (DVT) is considered as a risk factor of recurrent venous thromboembolism (VTE). We searched for risk factors associated with RTO after proximal DVT at the lower extremities.


METHODS
Using compression ultrasound, we evaluated the presence of RTO at 6 months after DVT (RTO defined as a residual thrombus occupying, at maximum compressibility, >/=20% of the vein lumen before compression).


RESULTS
We examined 126 Czech patients: mean age 57.5 years; 50.0% women, 68.3% femoral location of DVT (otherwise popliteal), RTO found in 45.2%. While accounting for covariates, in the whole population, RTO was significantly associated with following factors: (OR; 95% confidence limit; p value): male sex (2.01; 1.27-3.19; P=0.003), femoral location (2.76; 1.59-4.78; P=0.0003). In women, but not in men, an association was demonstrated for: concurrent pulmonary embolism (PE) (18.51; 1.85-185.7; P=0.0131), diabetes mellitus (4.62; 1.38-15.51; P=0.0133) and statin use (0.11; 0.02-0.62; P=0.0125). In contrast, in men RTO was associated with an unprovoked DVT (2.6; 1.26-5.34; P=0.0094).


CONCLUSIONS
In the whole study population, male sex and femoral location of DVT were positively associated with RTO. In women, concurrent PE and diabetes mellitus were risk factors for RTO, while the use of statins was a protective factor. There was a positive association between RTO and unprovoked DVT in men. These findings deserve further evaluation in a larger study.
Hirmerova
J
J
2nd Department of Internal Medicine, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic. hirmerova@fnplzen.cz
Seidlerova
J
J
Filipovsky
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018153:Czech Republic / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D016015:Logistic Models; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011152:Popliteal Vein / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000453:epidemiology; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014463:Ultrasonography; D054556:Venous Thromboembolism / Q000000981:diagnostic imaging / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D055815:Young Adult
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors