CC BY-NC-ND 4.0 · Thromb Haemost 2019; 19(10): 1675-1685
DOI: 10.1055/s-0039-1693461
Stroke, Systemic or Venous Thromboembolism
Georg Thieme Verlag KG Stuttgart · New York

Isolated Distal Deep Vein Thrombosis: Perspectives from the GARFIELD-VTE Registry

Sebastian M. Schellong
1  Medical Division 2, Municipal Hospital Dresden-Friedrichstadt, Dresden, Germany
,
Samuel Z. Goldhaber
2  Harvard Medical School, Harvard University, Boston, Massachusetts, United States
,
Jeffrey I. Weitz
3  Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada
,
Walter Ageno
4  Department of Medicine and Surgery, University of Insubria, Varese, Italy
,
Henri Bounameaux
5  Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
,
Alexander G. G. Turpie
6  McMaster University, Hamilton, Ontario, Canada
,
Pantep Angchaisuksiri
7  Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
,
Sylvia Haas
8  Department of Medicine, Technical University of Munich, Munich, Germany
,
Shinya Goto
9  Department of Medicine (Cardiology), Tokai University School of Medicine, Tokyo, Japan
,
Audrey Zaghdoun
10  Thrombosis Research Institute, London, United Kingdom
,
Alfredo Farjat
10  Thrombosis Research Institute, London, United Kingdom
,
Joern Dalsgaard Nielsen
11  Copenhagen University Hospital, Copenhagen, Denmark
,
Gloria Kayani
10  Thrombosis Research Institute, London, United Kingdom
,
Lorenzo G. Mantovani
12  University Degli Studi di Milano Bicocca, Milan, Italy
,
Paolo Prandoni
13  Arianna Foundation on Anticoagulation, Bologna, Italy
,
Ajay K. Kakkar
14  Thrombosis Research Institute, University College London, London, United Kingdom
› Author Affiliations
Funding The GARFIELD-VTE registry is an independent academic research initiative sponsored by the Thrombosis Research Institute (London, UK) and supported by an unrestricted research grant from Bayer Pharma AG (Berlin, Germany).
Further Information

Publication History

03 January 2019

29 May 2019

Publication Date:
01 August 2019 (eFirst)

  

Abstract

Isolated distal deep vein thrombosis (IDDVT) represents up to half of all lower limb DVT. This study investigated treatment patterns and outcomes in 2,145 patients with IDDVT in comparison with those with proximal DVT (PDVT; n = 3,846) and pulmonary embolism (PE; n = 4,097) enrolled in the GARFIELD-VTE registry. IDDVT patients were more likely to have recently undergone surgery (14.6%) or experienced leg trauma (13.2%) than PDVT patients (11.0 and 8.7%, respectively) and PE patients (12.7 and 4.5%, respectively). Compared with IDDVT, patients with PDVT or PE were more likely to have active cancer (7.2% vs. 9.9% and 10.3%). However, influence of provoking factors on risk of recurrence in IDDVT remains controversial. Nearly all patients (IDDVT, PDVT, and PE) were given anticoagulant therapy. In IDDVT, PDVT, and PE groups the proportion of patients receiving anticoagulant therapy was 61.4, 73.9, and 81.1% at 6 months and 45.8, 54.7, and 61.9% at 12 months. Over 12 months, the incidence of all-cause mortality, cancer, and recurrence was significantly lower in IDDVT patients than PDVT patients (hazard ratio [HR], 0.61 [95% confidence interval [CI], 0.48–0.77]; sub-HR [sHR], 0.60 [95% CI, 0.39–0.93]; and sHR, 0.76 [95% CI, 0.60–0.97]). Likewise, risk of death and incident cancer was significantly (both p < 0.05) lower in patients with IDDVT compared with PE. This study reveals a global trend that most IDDVT patients as well as those with PDVT and PE are given anticoagulant therapy, in many cases for at least 12 months.

Supplementary Material