Embolic Risk of Deep Vein Thrombosis is not Related to the Nature of Proximal Clot

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OBJECTIVE

To evaluate the incidence of symptomatic PE in patients with proximal embolic (floating) thrombus under standard anticoagulation.

MATERIAL AND METHODS

We analyzed patients with proximal venous thrombosis above the femoral vein. The main group (embolic thrombosis) included 60 patients with floating clot length of 9.3±2.3 cm, the control group (non-embolic thrombosis) — 164 patients with floating clot length of 2.2±2.2 cm (p<0.0001). The main endpoint was the incidence of symptomatic PE after onset of anticoagulation. In-hospital mortality and hospital-stay were also assessed.

RESULTS

Patients with embolic thrombosis were younger (59.6±14.7 and 64.9±16.4 years, respectively, p=0.029). Proximal level of thrombosis below the inguinal ligament was found in 49 (81.6%) and 102 (62%) patients, respectively (p=0.006). Mean hospital-stay was 9.2±3.3 and 6.0±1.9 days, respectively (p<0.0001). In-hospital PE occurred in 2 (1.2%) patients of the control group. No PE was observed in the main group (p=0.952). There were no deaths in both groups.

CONCLUSION

Incidence of symptomatic PE is similar in patients with embolic and non-embolic deep vein thrombosis receiving adequate anticoagulation in accordance with clinical guidelines.

Keywords:

deep vein thrombosis

pulmonary embolism

floating thrombus

vena cava filter

Authors:

Rylnikov D.V.

Pirogov Russian National Research Medical University

ORCID: 0009-0004-8196-9725

Seliverstov E.I.

Pirogov Russian National Research Medical University;
Pirogov Moscow City Clinical Hospital No. 1

SPIN RSCI: 9011-1989
Scopus AuthorID: 24332884500
ORCID: 0000-0002-9726-4250

An E.S.

Pirogov Russian National Research Medical University;
Pirogov Moscow City Clinical Hospital No.1

ORCID: 0009-0000-2539-1974

Kuperin A.S.

Pirogov Russian National Research Medical University;
Pirogov Moscow City Clinical Hospital No. 1

ORCID: 0009-0000-5661-3533

Lebedev I.S.

Pirogov Russian National Research Medical University

ORCID: 0000-0001-7956-3807

Zolotukhin I.A.

Pirogov Russian National Research Medical University;
Pirogov Moscow City Clinical Hospital No. 1

SPIN RSCI: 3426-2981
Scopus AuthorID: 8312153900
ResearcherID: P-5001-2016
ORCID: 0000-0002-6563-0471

Received:

29.03.2024

Accepted:

05.04.2024

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