Residual vein obstruction to predict the risk of recurrent venous thromboembolism in patients with deep vein thrombosis: A systematic review and meta-analysis.
J Thromb Haemost. 2011 Mar 7;
Authors: Carrier M, Rodger M, Wells PS, Righini M, Le Gal G
Background: Residual vein obstruction (RVO) detected on compression ultrasonography of the leg after a few months on anticoagulation therapy might be able to identify patients with deep vein thrombosis (DVT) at high risk of having a recurrent venous thromboembolism (VTE). Purpose: To determine whether RVO is associated with an increased risk of recurrent events in patients with DVT. Data Source: A systematic literature search strategy was conducted using MEDLINE, EMBASE and the Cochrane Register of Controlled Trials. Study Selection: We selected 14 articles (9 prospective cohort studies and 5 randomized controlled trials) that included patients with DVT who had a assessment for RVO using compression ultrasonography. Data extraction: Two reviewers independently extracted data onto standardized forms. Data Synthesis: Overall, the presence of RVO is not associated with an increased risk of recurrent VTE (OR: 1.24, 95% CI: 0.9 to 1.7) in patients with unprovoked DVT that stopped oral anticoagulation therapy at the time of RVO assessment. However, RVO was significantly associated with recurrent VTE in patients with any (unprovoked and provoked) DVT: OR 1.5 (95% CI: 1.1 to 2.0). Conclusion: Residual vein obstruction was associated with a modest increased risk of recurrent VTE in patients with DVT (unprovoked and provoked). However, RVO does not seem to be a predictor of recurrent VTE in patients with unprovoked DVT following anticoagulation discontinuation. Further prospective studies are needed to assess the role of RVO in patients with unprovoked DVT.
PMID: 21382171 [PubMed - as supplied by publisher]