Venous anomalies: an underrecognized but important cause of venous thromboembolism

Blood Vessels, Thrombosis & Hemostasis Pub Date : 2024-05-22 DOI:10.1016/j.bvth.2024.100013

Joanne So , Caroline Dix , Warren Clements , Harry Gibbs , Huyen Tran , James D. McFadyen

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Abstract

Anatomical variants, such as May-Thurner syndrome (MTS) and inferior vena cava (IVC) variants, are underrecognized causes of deep venous thrombosis (DVT), despite affecting management. We aimed to identify the proportion of anatomical variants in proximal lower limb DVT. A retrospective cohort study was performed with cases of acute proximal DVT from 2014 to 2021 identified from ICD-10 codes. We identified 4731 DVTs and included 1268 proximal DVTs. Thirty-six (2.84%) had an anatomical variant (25 MTS and 11 IVC variants), with a rate of 14.39% in females <50 years old. Compared with nonvariant DVTs, they were more likely to be unprovoked (81% vs 23%), younger (median age, 37 vs 63 years), female (67% vs 37%), and have postthrombotic syndrome (22% vs 9%). Variants frequently received thrombolysis (58% vs 1%) or angioplasty (47% vs 0%) and indefinite anticoagulation (83% vs 40%). Further investigation for variants should be considered for high-risk patients, as variants affect management.

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静脉畸形--静脉血栓栓塞症的一个未被充分认识的重要原因

摘要解剖变异，如梅-特纳综合征（MTS）和下腔静脉（IVC）变异，是深静脉血栓形成（DVT）的原因之一，尽管影响了治疗，但却未得到充分认识。我们旨在确定解剖变异在下肢近端深静脉血栓中的比例。我们进行了一项回顾性队列研究，根据 ICD-10 编码确定了 2014 年至 2021 年的急性下肢近端深静脉血栓病例。我们确定了 4731 例深静脉血栓，其中包括 1268 例近端深静脉血栓。36例（2.84%）有解剖变异（25例MTS和11例IVC变异），其中14.39%为50岁女性。与非变异型深静脉血栓相比，变异型深静脉血栓更有可能是无诱因的（81% 对 23%）、更年轻（中位年龄为 37 岁对 63 岁）、女性（67% 对 37%），并且有血栓后综合征（22% 对 9%）。变异者经常接受溶栓治疗（58% 对 1%）或血管成形术（47% 对 0%），并接受无限期抗凝治疗（83% 对 40%）。由于变异会影响治疗，因此应考虑对高危患者进行进一步的变异检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Blood Vessels, Thrombosis & Hemostasis

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