Recurrence in isolated distal DVT after anticoagulation: a systematic review and meta-analysis of axial and muscular venous thrombosis.

IF 2.6 4区 医学 Q2 HEMATOLOGY Thrombosis Journal Pub Date : 2024-07-01 DOI:10.1186/s12959-024-00623-6
Wen-Tao Yang, Zhen-Yi Jin, Chun-Min Li, Jia-Hao Wen, Hua-Liang Ren
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Abstract

Objective: To identify recurrent venous thromboembolism (VTE) after discontinuation of anticoagulation in patients with isolated distal deep vein thrombosis based on its anatomic localization (axial or muscular veins).

Methods: Data were sourced from PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases in the time period up to October 2023. The study followed PRISMA guidelines using a registered protocol (CRD42023443029). Studies reporting recurrent VTE in patients with axial or muscular DVT were included in the analysis.

Results: Five studies with a total of 1,403 participants were evaluated. The results showed a pooled odds ratio of 1.12 (95% confidence interval 0.77-1.63) between axial and muscular DVT. Heterogeneity was low (I2 = 0%, p = 0.91) and there was no significant difference in the rate of recurrent VTE between axial and muscular DVT in each subgroup.

Conclusions: Muscular and axial DVT showed comparable recurrent VTE rates after anticoagulation. However, uncertainties regarding the possibility of recurrence affecting the popliteal vein or resulting in pulmonary embolism following muscular DVT anticoagulation persisted. Randomized trials in patients with isolated distal DVT are still needed to clarify its prognosis for different anatomical thrombus locations.

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抗凝治疗后孤立性远端深静脉血栓复发:轴性和肌肉性静脉血栓的系统回顾和荟萃分析。
目的根据解剖学定位(轴静脉或肌肉静脉),识别孤立性远端深静脉血栓形成患者停止抗凝治疗后复发的静脉血栓栓塞症(VTE):数据来源于PubMed、Embase、Cochrane Library、Web of Science和ClinicalTrials.gov数据库,时间截至2023年10月。研究遵循 PRISMA 指南,使用注册协议(CRD42023443029)。分析纳入了报告轴性或肌性深静脉血栓患者复发性 VTE 的研究:共评估了五项研究,共有 1,403 人参与。结果显示,轴性深静脉血栓与肌性深静脉血栓之间的合并几率比为 1.12(95% 置信区间为 0.77-1.63)。异质性较低(I2 = 0%,P = 0.91),在每个亚组中,轴性和肌性深静脉血栓的复发率没有显著差异:结论:抗凝治疗后,肌性和轴性深静脉血栓的复发率相当。结论:肌性和轴性深静脉血栓形成在抗凝治疗后的复发率相当,但在肌性深静脉血栓形成抗凝治疗后,影响腘静脉或导致肺栓塞的复发可能性仍存在不确定性。仍需对孤立性远端深静脉血栓患者进行随机试验,以明确不同解剖位置血栓的预后。
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来源期刊
Thrombosis Journal
Thrombosis Journal Medicine-Hematology
CiteScore
3.80
自引率
3.20%
发文量
69
审稿时长
16 weeks
期刊介绍: Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis. Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.
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