INTRODUCTION:Ovarian vein thrombosis (OVT) is a rare complication of pregnancy and can result in sepsis, extensive thrombosis and secondary venous thromboembolism (VTE). Treatments range from observation to anticoagulation and antibiotics. This study aims to identify the incidence of secondary VTE and factors that correlate with subsequent VTE.METHODS:After institutional review board approval, a cross-sectional study of patients diagnosed with OVT in the peripartum period from 2012 to 2020 at our institution was performed. The incidence of secondary VTE and their clinical management was reviewed. Descriptive statistics were performed to identify risk factors for secondary VTE. Numeric variables were compared using Mann-Whitney U test, and categorical variables were compared using chi-square or Fischer’s exact test.RESULTS:A total of 37 postpartum patients with OVT were included. The incidence of secondary VTE was 16.2% (6 patients). Patient characteristics including age, race, BMI, tobacco use, mode of delivery, cesarean hysterectomy, and chorioamnionitis were similar between patients with OVT alone and OVT with secondary VTE (P=.918, .911, 1, .115, 1, .62, .535, respectively). Radiographic measurement of OVT extension into the IVC or renal veins as both continuous or nominal variables did not confer increased risk of secondary VTE.CONCLUSION:Secondary VTE following OVT occurred in 16% of women in this select population. No clinical or demographic factors were found to be significant for a higher risk of developing VTE. Although OVT is rare, it is associated with significant maternal morbidity and mortality. Future studies are needed to identify high-risk patients for secondary outcomes of OVT and improve therapeutic guidelines.
Based on observations at angiography, it was hypothesized that angiomyolipomas (AMLs) associated with tuberous sclerosis complex (TSC) have a more robust parasitic blood supply and require more complex embolization involving lower order vessels compared with the non-TSC patients' AMLs. This was a retrospective review of 71 patients who underwent angiography and embolization for renal AML at multiple centers within a single health system. All of the patients with TSC (11/11) were found to have “complex” tumor vascular supply. Of the patients with sporadic AML, 51/60 (85%) had “simple” tumor vascular supply. Sporadic cases with a complex tumor blood supply were larger tumors, with an average size of 11.5 cm. This study supports our hypothesis that AMLs associated with TSC have more complex tumor vascularity compared with sporadic lesions, and aims to better prepare interventionalists to deal with the complex cases.
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