Clinical Significance of Isolated Retrovalvular Deep Venous Thrombus

Abstract

Objective We sought to determine the natural progression of isolated thrombus behind valve leaflets in deep veins that is not associated with any other evidence of deep venous thrombosis (DVT). Methods We prospectively evaluated patients that were sent to us for evaluation of DVT. Duplex venous examination protocol established by the American College of Radiology was used. Only those patients who were found to have thrombus behind valve leaflets and did not have any other evidence of DVT were included in this study. Results During a period of 5 months, eight patients were found to have retrovalvular thrombus. The patients were further evaluated by follow-up duplex venous examination or telephone interview. The six patients in whom repeat duplex venous examination was performed demonstrated either no progression or complete resolution of thrombus. Two patients who refused to return for repeat duplex examination were reached for telephone interview and revealed no further symptoms that would indicate progression of deep vein thrombosis. Conclusions This study provides information on the natural course of isolated retrovalvular thrombus. These thrombi either remain stable or resolve and appear to not require anticoagulation. A large-scale study will be needed to corroborate these findings.