Prevalence of venous obstructions in (recurrent) venous thromboembolism: a case-control study
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RESEARCH
Open Access
Prevalence of venous obstructions in (recurrent) venous thromboembolism: a case-control study Pascale Notten1,2† , Rob H. W. Strijkers3†, Irwin Toonder3, Hugo ten Cate2,3,4 and Arina J. ten Cate-Hoek2,3,4,5*
Abstract Background: The role of venous obstructions as a risk factor for recurrent venous thromboembolism has never been evaluated. This study aimed to determine whether there is a difference in prevalence of venous obstructions between patients with and without recurrent venous thromboembolism. Furthermore, its influence on the development of post-thrombotic syndrome and patient-reported quality of life was assessed. Methods: This matched nested case-control study included 32 patients with recurrent venous thromboembolism (26 recurrent deep-vein thrombosis and 6 pulmonary embolism) from an existing prospective cohort of deep-vein thrombosis patients and compared them to 24 age and sex matched deep-vein thrombosis patients without recurrent venous thromboembolism. All participants received standard post-thrombotic management and underwent an additional extensive duplex ultrasonography. Post-thrombotic syndrome was assessed by the Villaltascale and quality of life was measured using the SF36v2 and VEINES-QOL/Sym-questionnaires. Results: Venous obstruction was found in 6 patients (18.8%) with recurrent venous thromboembolism compared to 5 patients (20.8%) without recurrent venous thromboembolism (Odds ratio 0.88, 95%CI 0.23–3.30, p = 1.000). After a median follow-up of 60.0 months (IQR 41.3–103.5) the mean Villalta-score was 5.55 ± 3.02 versus 5.26 ± 2.63 (p = 0.909) and post-thrombotic syndrome developed in 20 (62.5%) versus 14 (58.3%) patients, respectively (Odds ratio 1.19, 95%CI 0.40–3.51, p = 0.752). If venous obstruction was present, it was mainly located in the common iliac vein (n = 7, 63.6%). In patients with an objectified venous obstruction the mean Villalta-score was 5.11 ± 2.80 versus 5.49 ± 2.87 in patients without venous obstruction (p = 0.639). Post-thrombotic syndrome developed in 6 (54.5%) versus 28 (62.2%) patients, respectively (Odds ratio 1.37, 95%CI 0.36–5.20, p = 0.736). No significant differences were seen regarding patient-reported quality of life between either groups. (Continued on next page)
* Correspondence: [email protected] † Pascale Notten and Rob H. W. Strijkers contributed equally to this work. 2 CARIM, Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University Medical Centre, P.O. Box 616, Maastricht 6200 MD, the Netherlands 3 Laboratory for Clinical Thrombosis and Hemostasis, Maastricht University, P.O. Box 616, Maastricht 6200 MD, The Netherlands Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original aut
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