Asymptomatic pulmonary embolism in patients with symptomatic deep vein thrombosis of the extremities: Three year results of a prospective study

Kerasidis, Stavros; Galyfos, George; Kastrisios, Georgios; Stamatatos, Ioannis; Stefanidis, Ioannis; Giannakakis, Sotirios; Geropapas, Georgios; Papacharalampous, Gerasimos; Maltezos, Chrisostomos

doi:10.5455/aces.20150809085542

Cited by 2 publications

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“…18 Regarding the risk for thrombosis recurrence, up to onethird of cases with hereditary thrombophilia and DVT will recur within the following 4 years. 19 In 2001, Emmerich et al conducted a pooled analysis of 8 case-control studies looking at 2310 cases and 3204 controls to estimate the risk of thrombosis in double heterozygotes for factor V Leiden and the prothrombin G20210A mutations. 20 The data showed an odds ratio for VTE in double heterozygotes of 20.0 (11.1-36.1).…”

Section: Discussionmentioning

confidence: 99%

Direct oral anticoagulants for deep vein thrombosis among patients with hereditary thrombophilia—A cohort study

Galyfos,

Chamzin,

Charalampopoulos

et al. 2023

Phlebology

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Objectives to evaluate direct oral anticoagulants (DOACs) in patients with hereditary thrombophilia and deep venous thrombosis (DVT). Methods This is a retrospective observational study. Results In total, 45 patients were treated between 01/2012 and 12/2022 (mean follow-up: 1.5 +/− 0.3 years). The most frequent thrombophilias were heterozygous V Leiden (20%), heterozygous MTHFR C677T (37.8%), heterozygous MTHFR A1298C (24.4%), and hyperhomocysteinemia (26.7%). The patients received rivaroxaban ( n = 19), apixaban ( n = 15), and dabigatran ( n = 11). Three cases presented symptoms’ recurrence without evidence of thrombosis’ recurrence (two under rivaroxaban and one under apixaban; p > .05). These patients improved under parenteral anticoagulation and were further treated with dabigatran. No other event or major bleeding occurred during the follow-up. The presence of more than two factors was associated with acute recurrence of symptoms (OR = 25.9; 95% CI [1.454–461.262]; p = .026). Conclusions DOACs seem to be safe and efficient for patients with hereditary thrombophilia and DVT. The presence of more than two thrombophilia factors is associated with a higher risk for symptom recurrence. Although statistically non-significant, symptoms’ recurrence was also observed more frequently among patients under anti-Xa inhibitors than antithrombin inhibitors. This should be verified in larger comparative studies.

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Section: Discussionmentioning

confidence: 99%

Direct oral anticoagulants for deep vein thrombosis among patients with hereditary thrombophilia—A cohort study

Galyfos,

Chamzin,

Charalampopoulos

et al. 2023

Phlebology

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“…In contrast to the two aforementioned studies, our study specifically focused on ambulant outpatients investigated in the community. Kerasidis et al 18 reported a rate of 32% (39/122) incidental PE in patients treated for symptomatic DVT in a tertiary vascular surgery department. When excluding 18 patients with upper limb or iliac thrombus, the rate of IPE in lower limb DVT was 27.8% (29.2% in proximal and 22.2% in distal DVT).…”

Section: Discussionmentioning

confidence: 99%

“…Kerasidis et al 18 . reported a rate of 32% (39/122) incidental PE in patients treated for symptomatic DVT in a tertiary vascular surgery department.…”

Section: Discussionmentioning

confidence: 99%

Incidental central pulmonary emboli in outpatients with deep vein thrombosis

Troupis,

Berman,

Hammerschlag

et al. 2023

Internal Medicine Journal

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BackgroundWhile it has been demonstrated that large asymptomatic pulmonary embolism (PE) can occur, many studies have assessed inpatients or patients with known risk factors for venous thromboembolism (such as malignancy). There are few data regarding incidental PE in outpatients with deep vein thrombosis (DVT) or assessing whether these emboli occur centrally or peripherally in the pulmonary arteries.AimsTo determine the rates of incidental central and peripheral PE in outpatients with proximal and distal DVT.MethodsThis was a retrospective cross‐sectional study of 120 patients attending our community imaging clinic between January 2015 and March 2020, with ultrasound‐confirmed lower limb DVT, and subsequent computed tomography pulmonary angiogram (CTPA) within 24 h. Exclusion criteria were symptoms indicative of PE. Imaging reports were retrospectively reviewed to record the proximity of DVT and the location of any PE as either central (pulmonary trunk or main pulmonary arteries) or peripheral (lobar, segmental or subsegmental pulmonary arteries).ResultsIncidental PE occurred in 71 patients (59.2%), with a rate of 77.5% in proximal and 50.0% in distal DVT. Sixteen patients had central PE (13.3% of all patients with DVT; 22.5% of all patients with PE). Two patients (both with proximal DVT) had PE in the pulmonary trunk.ConclusionsIncidental PE occur frequently in outpatients with lower limb DVT, including the possibility of asymptomatic central emboli. Further studies with larger patient cohorts would be useful to assess the utility of baseline chest imaging in outpatients with DVT.

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Asymptomatic pulmonary embolism in patients with symptomatic deep vein thrombosis of the extremities: Three year results of a prospective study

Cited by 2 publications

References 0 publications

Direct oral anticoagulants for deep vein thrombosis among patients with hereditary thrombophilia—A cohort study

Direct oral anticoagulants for deep vein thrombosis among patients with hereditary thrombophilia—A cohort study

Incidental central pulmonary emboli in outpatients with deep vein thrombosis

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