Increased risk of deep vein thrombosis and pulmonary thromboembolism in patients with aortic aneurysms: A nationwide cohort study

Abstract

Studies on the association between aortic aneurysm (AA) and the subsequent risk of venous thromboembolism (VTE) are limited to a few case reports and investigations which only focused on surgical effects. Therefore, we used the National Health Insurance Research Database to clarify whether patients with AAs have a heightened risk of subsequent VTEs, including deep vein thrombosis (DVT) and pulmonary embolism (PE). Our retrospective cohort study comprised patients aged ≥ 18 years who received a diagnosis of an AA and were hospitalized at any point during 2000–2010 (n = 16,630). Each AA patient was frequency-matched to 4 non-AA hospitalized patients based on age, sex, and index year (n = 66,453). The Cox proportional hazard regressions model was used to estimate the adjusted effect of AAs on VTE risk. The overall incidence of DVT and PE was higher in the patients with AA than in the non-AA group patients (23.5 versus 13.2 and 13.5 versus 7.98/1,000 person-years). After adjustment for age, sex, duration of hospitalization in the study period, and comorbidities, patients with AAs were associated with a 1.88-fold higher risk of DVT and 1.90-fold higher risk of PE compared to the non-AA cohort. Patients with abdominal AAs were more likely to develop DVT, whereas thoracic AA patients were more likely to develop PE. A diagnosis of a ruptured AA was associated with a substantially increased risk of DVT. Surgical treatment of AAs was associated with a heightened risk of VTE within 6-months post-operation. Our study demonstrates that AAs are associated with an increased risk of subsequent VTE. Future investigations are encouraged to delineate the mechanisms underlying this association and to evaluate the cost-effectiveness of screening for VTEs in patients with AAs.

Thrombus risk versus bleeding risk: a clinical conundrum

“…As such, there is scarcity in the literature of such cases and optimal management. A cohort study by Lee et al 4 found that an aortic aneurysm serves as a risk factor for the development of DVT 4. Kuivaniemi et al 5 suggested this phenomenon was likely to be due to triggering of an inflammatory reaction following the degeneration of the tunica media within the aorta 5.…”

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

“…These developments correspond with the decline in smoking rates among men, as well as the implementation of screening programs and subsequent uptake in elective repairs [ 15 , 20 ]. Less common complications of AAAs include aortoenteric or aortocaval fistulae and iliac vein compression resulting in deep vein thrombosis or emboli [ 40 , 41 , 42 ].…”

Tiefe Venenthrombose als Primärsymptom eines abdominellen Aortenaneurysmas

“…Ebenfalls ist ein Fall von einseitiger Bein-schwellungdurcheinAAA mitaortokavaler Fistel beschrieben [10]. Im Vergleich zur gesunden Allgemeinbevölkerung haben Patienten mit Aortenaneurysmen ein 1,88fach erhöhtes Risiko für eine TVT, wobei eine abdominelle Aneurysmamanifestation im Gegensatz zur thorakalen das Risiko noch weiter erhöht [4].…”