J Vasc Surg Venous Lymphat Disord. 2021 Feb 9:S2213-333X(21)00084-6. doi: 10.1016/j.jvsv.2021.01.018. Online ahead of print.
ABSTRACT
OBJECTIVE: Although distal deep vein thrombosis (DDVT) is more frequently diagnosed with better ultrasonographic imaging quality, there has been conflicting data on the best way to manage this event. The aim of this review is to summarize the current and evidence-based recommendations for the diagnosis and management of DDVT in addition to providing a summary of the most recent societal guideline recommendations.
METHODS: A literature review of distal deep vein thrombosis was performed. PubMed databases were queried for articles on the epidemiology, risk factors, diagnosis, and management of DDVT.
RESULTS: The prevalence of isolated DDVT has been reported in a broad range. Reported risk factors include older age, active malignancy, low degree of mobility, acute infection, and atrial fibrillation. Based on more evidence, anticoagulation therapy was associated with reduced risk of recurrent VTE and or thrombus propagation compared to conservative management. However, anticoagulation was associated with increased risk of bleeding in number of included studies. The rate of VTE recurrence ranged from 7% to 23% over a follow-up period ranging from 3 months to 8 years. Significant risk factors for VTE recurrence included cancer, older age, unprovoked event, and inpatient status.
CONCLUSIONS: There is scarce literature addressing the diagnosis and management of DDVT. Further research is needed to standardize the best approach to diagnose and treat patients with DDVT.
PMID:33578030 | DOI:10.1016/j.jvsv.2021.01.018