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Yao J, Han M, Shi J, Wang W, Zhang J, Zhang Y. Prognosis and Factors 4 to 10 Years After Deep Vein Thrombosis: A Long-Term Follow-up Cohort Study. Clin Appl Thromb Hemost 2024; 30:10760296241266820. [PMID: 39140994 DOI: 10.1177/10760296241266820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
Post-thrombotic syndrome (PTS) is one of the most common long-term complications of lower extremity deep vein thrombosis (DVT). In order to study the long-term adverse prognosis of patients with DVT, explore the influencing factors for the prognosis of DVT, and provide a reliable reference for future research in the field of venous thrombosis, we collected and summarized information about the incidence of PTS, the PTS score and grading, the associated symptoms and drug-related adverse reactions in 501 patients with DVT. In our study, 54.1% of patients with DVT (271 of 501) experienced indications and manifestations of PTS, the male to female ratio was approximately 1:1. During the long-term follow up, the most common symptoms of PTS were anterior tibial edema and pain. By statistical analysis, we found that the outcome of thrombosis was the influencing factor of PTS score (1-4 points, P<.05). The grading of PTS was primarily influenced by the history of varicose veins and DVT in the lower extremities. The duration of taking antithrombotic drugs affected the outcome of thrombosis (P<.05), especially among the female patients. In addition, varied factors, such as lower extremity DVT complicated with pulmonary embolism and the duration of antithrombotic drug use were found to increase the chances of experiencing drug-related adverse reactions (odds ratio [OR]=2.798, 95% confidence interval [CI]: 1.413-5.541 / OR=2.778, 95% CI: 1.231-6.269). The above 2 factors were significant only among female patients with DVT (OR=4.03, 95% CI: 1.608-10.103 / OR=3.918, 95% CI: 1.123-13.669).
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Affiliation(s)
- Jinhan Yao
- Department of Obstetrics and Gynecology, Affliated Hospital of Nantong University, Nantong, China
- Medical College, Nantong University, Nantong, China
| | - Mengru Han
- Department of Obstetrics and Gynecology, Affliated Hospital of Nantong University, Nantong, China
- Medical College, Nantong University, Nantong, China
| | - Jin Shi
- Department of Obstetrics and Gynecology, Affliated Hospital of Nantong University, Nantong, China
- Medical College, Nantong University, Nantong, China
| | - Weina Wang
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Shanghai, China
| | - Jiayi Zhang
- Department of Obstetrics and Gynecology, The Ninth People's Hospital of Suzhou, Suzhou, China
| | - Yuquan Zhang
- Department of Obstetrics and Gynecology, Affliated Hospital of Nantong University, Nantong, China
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Shen S, Shan C, Lan Y, Chen Y, Li J, Guo X, Ji H, Li M, Cong M. Combined high-resolution 3D CUBE T1-weighted imaging and non-contrast-enhanced magnetic resonance venography for evaluation of vein stenosis in May-Thurner syndrome. Phlebology 2021; 37:14-20. [PMID: 34496697 DOI: 10.1177/02683555211045189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the feasibility of high-resolution MRI 3-dimensional (3D) CUBE T1-weighted magnetic resonance imaging (MRI) in combination with non-contrast-enhanced (NCE) magnetic resonance venography (MRV) for the assessment of lumen stenosis in May-Thurner syndrome. METHODS Twenty-nine patients underwent computed tomography venography (CTV) and high-resolution MRI-CUBE T1, and NCE MRV acquisitions. ANOVA and LSD tests were used to compare the stenosis rate and narrowest and distal diameters of the vessel lumen. RESULTS There were no significant differences in the estimated stenosis rate between CTV, CUBE T1, and NCE MRV (p = 0.768). However, there were significant differences in the measured stenosis diameters of the left common iliac vein (LCIV), with CTV giving the largest mean diameter and CUBE had the smallest mean diameter (p < 0.05). The measured normal LCIV diameters did not significantly differ between MRV and CUBE (p = 0.075) but were significantly larger on CTV than on MRV and CUBE (p < 0.05). CONCLUSIONS Compared with CTV, a combination of CUBE and MRV could provide an improved assessment of the degree of lumen stenosis in May-Thurner syndrome and demonstrate acute thrombosis. MRI underestimates the diameter of the vessel in comparison with CTV. MRI can be a substitute tool for Duplex ultrasound and CTV.
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Affiliation(s)
- Shanshan Shen
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, ChinaHebei General Hospital, Shijiazhuang, Hebei, China
| | - Chunhui Shan
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, ChinaHebei General Hospital, Shijiazhuang, Hebei, China
| | - Yanqin Lan
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, ChinaHebei General Hospital, Shijiazhuang, Hebei, China
| | - Yingmin Chen
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, ChinaHebei General Hospital, Shijiazhuang, Hebei, China
| | - Jikuan Li
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, ChinaHebei General Hospital, Shijiazhuang, Hebei, China
| | - Xiaowan Guo
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, ChinaHebei General Hospital, Shijiazhuang, Hebei, China
| | - Hong Ji
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, ChinaHebei General Hospital, Shijiazhuang, Hebei, China
| | - Min Li
- GE Healthcare, MR Research China, Beijing, China
| | - MengDi Cong
- Department of Radiology, Hebei Children's Hospital, Shijiazhuang, Hebei, China
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Siddiqa A, Haider A, Fortuzi K, Adrish M, Ishak C. May-Thurner Syndrome: A Rare Case of Unilateral Deep Vein Thrombosis in an Elderly Woman. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929897. [PMID: 34460807 PMCID: PMC8420678 DOI: 10.12659/ajcr.929897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Patient: Female, 78-year-old
Final Diagnosis: May-Thurner syndrome
Symptoms: Lower extremity edema • lower extremity pain
Medication: —
Clinical Procedure: —
Specialty: Critical Care Medicine • Hematology • General and Internal Medicine • Radiology
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Affiliation(s)
- Ayesha Siddiqa
- Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA
| | - Asim Haider
- Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA
| | - Ked Fortuzi
- Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA
| | - Muhammad Adrish
- Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA.,Department of Pulmonary Critical Care, BronxCare Health System, Bronx, NY, USA
| | - Charbel Ishak
- Department of Interventional Radiology, BronxCare Health System, Bronx, NY, USA
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Cohen CT, Kirk S, Desai SB, Kukreja KU, Srivaths L. Diagnosis, Clinical Characteristics, and Treatment Modalities of Adolescent May-Thurner Syndrome-associated Deep Venous Thrombosis. J Pediatr Hematol Oncol 2021; 43:e346-e350. [PMID: 33093351 DOI: 10.1097/mph.0000000000001968] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/13/2020] [Indexed: 12/17/2022]
Abstract
May-Thurner syndrome (MTS) predisposes individuals to develop lower extremity deep venous thrombosis (DVT) because of compression of the left common iliac vein. Diagnosis of the anatomic obstruction is critical for effective therapy, as treatment by interventional radiology is often required in addition to anticoagulation to prevent thrombus progression and recurrence. The authors performed a retrospective review of adolescent patients who presented with MTS-associated DVT at a pediatric tertiary care center from 2009 to 2018 to assess for delays in MTS diagnosis after the presentation. Fourteen patients (median age 16.5 y, range, 13.8 to 17.9 y) were included, no DVTs were provoked by a central venous catheter. The median time from DVT to MTS diagnosis was 0.65 months (range, 0 to 21.5 mo). The initial imaging modalities used for DVT diagnosis were not able to diagnosis MTS. All patients were treated with anticoagulation and 13 underwent interventional therapy. Four patients had thrombus progression or recurrence, whereas 6 had complete thrombus resolution on follow-up imaging. Three patients who had a delayed MTS diagnosis had clinical worsening despite therapeutic anticoagulation requiring rehospitalization. Adolescent patients with "unprovoked" left lower extremity DVT should undergo appropriate imaging to diagnose MTS to allow for adequate medical and interventional therapy.
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Affiliation(s)
- Clay T Cohen
- Department of Pediatrics, Section of Hematology-Oncology, Texas Children's Cancer and Hematology Centers
| | - Susan Kirk
- Department of Pediatrics, Section of Hematology-Oncology, Texas Children's Cancer and Hematology Centers
| | - Sudhen B Desai
- Department of Radiology, Section of Interventional Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Kamlesh U Kukreja
- Department of Radiology, Section of Interventional Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Lakshmi Srivaths
- Department of Pediatrics, Section of Hematology-Oncology, Texas Children's Cancer and Hematology Centers
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Nickler M, Haubitz S, Méndez A, Gissler M, Stierli P, Kieback A. Phlegmasia cerulea dolens - an uncommon but alarming manifestation of deep vein thrombosis. VASA 2020; 49:422-426. [PMID: 32646321 DOI: 10.1024/0301-1526/a000894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In phlegmasia cerulea dolens (PCD), immediate diagnosis and prompt treatment is crucial for limb salvage. Aggressive treatment options including venous intervention, thrombolysis and/or surgical thrombectomy should be considered. Due to the lack of data, the most appropriate intervention depends upon etiology of PCD, clinical presentation and patient's bleeding risk.
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Affiliation(s)
- Manuela Nickler
- Medical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Sebastian Haubitz
- Medical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland.,Medical University Department, Division of Infectiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Adriana Méndez
- Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Martin Gissler
- Department of Radiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Peter Stierli
- Surgical Department, Division of Vascular Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Arne Kieback
- Medical University Department, Division of Angiology, Kantonsspital Aarau, Aarau, Switzerland
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