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深静脉血栓形成晚期(>2年)复发的发生率、危险因素及特征

The Incidence, Risk Factors and Characteristics of Late (>2 Years) Recurrence of Deep Venous Thrombosis.

作者信息

Wu Bo, Fu Jian, Wang Haiyang, Yan Haiyan, Sun Jianming, Wang Haoyuan, Zhang Lili

机构信息

Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.

General Practice, Chongqing University Fuling Hospital, Chongqing, China.

出版信息

Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296251332937. doi: 10.1177/10760296251332937. Epub 2025 Apr 13.

Abstract

ObjectiveRecurrent deep venous thrombosis (RDVT) is a relatively frequent phenomenon; however, scarce literature is available on late RDVT (>2 years). This study aimed to investigate the incidence, associated risk factors, and characteristics of late RDVT.MethodsWe conducted a retrospective analysis of patients diagnosed with symptomatic lower extremity deep venous thrombosis (DVT) between April 2017 and April 2022. The incidence and mortality rates of late RDVT, as well as the demographic data, risk factors, and characteristics, were assessed. Additionally, a comprehensive Cox regression analysis was performed to evaluate 14 potential risk factors.ResultsOf the 638 patients with DVT, 89 (13.9%) experienced recurrence during a mean follow-up period of 30.10 ± 15.23 months. The RDVT group comprised 50 males and 39 females (the male-to-female ratio: 50/39), with a mean age of 64.08 ± 13.23 years (the age range: 26-88 years). Among them, early recurrence was observed in 57 (64%) patients, while late recurrence occurred in 32 (36%) after their initial symptomatic DVT episode. Late RDVT predominantly manifested in the contralateral lower extremity. Multivariate Cox regression analysis further identified proximal DVT, immobility, non-retrieved inferior vena cava filter (IVCF), and ≥50% stent extension into the inferior vena cava (IVC) as significant risk factors for late RDVT. Moreover, mortality among patients with late RDVT was low, with 2 (6.25%) dying during the follow-up period.ConclusionsLate RDVT is relatively infrequent within the RDVT cohort and primarily manifests in the contralateral lower extremity. Furthermore, patients with late RDVT have a low mortality rate. Proximal DVT, immobility, non-retrieved IVCF, and ≥50% stent extension into the IVC are strongly correlated with the development of late RDVT.

摘要

目的

复发性深静脉血栓形成(RDVT)是一种相对常见的现象;然而,关于晚期RDVT(>2年)的文献却很少。本研究旨在调查晚期RDVT的发生率、相关危险因素及特征。

方法

我们对2017年4月至2022年4月期间诊断为有症状的下肢深静脉血栓形成(DVT)的患者进行了回顾性分析。评估了晚期RDVT的发生率和死亡率,以及人口统计学数据、危险因素和特征。此外,进行了全面的Cox回归分析以评估14个潜在危险因素。

结果

在638例DVT患者中,89例(13.9%)在平均30.10±15.23个月的随访期内出现复发。RDVT组包括50名男性和39名女性(男女比例:50/39),平均年龄为64.08±13.23岁(年龄范围:26 - 88岁)。其中,57例(64%)患者出现早期复发,32例(36%)在首次出现症状性DVT发作后出现晚期复发。晚期RDVT主要表现在对侧下肢。多因素Cox回归分析进一步确定近端DVT、活动受限、未取出的下腔静脉滤器(IVCF)以及≥50%的支架延伸至下腔静脉(IVC)是晚期RDVT的重要危险因素。此外,晚期RDVT患者的死亡率较低,随访期间有2例(6.25%)死亡。

结论

晚期RDVT在RDVT队列中相对少见,主要表现在对侧下肢。此外,晚期RDVT患者的死亡率较低。近端DVT、活动受限(不活动)、未取出的IVCF以及≥50%的支架延伸至IVC与晚期RDVT的发生密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/441c/12033397/99fae51d9d6f/10.1177_10760296251332937-fig1.jpg

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