Extent of thrombus evaluated in patients with recurrent and first deep vein thrombosis

Abstract

Objectives: The objective of this retrospective study was to document the extent of thrombus in patients with recurrent and first deep vein thrombosis (DVT). Patients and Methods: A total of 864 patients with DVT of the leg were enrolled in the study. They were divided into two groups: patients with recurrent DVT (n = 233) of the leg, and patients with first DVT of the leg (n = 631). In both groups the extent of the thrombus was evaluated by duplex scanning, contrast venography, or magnetic resonance imaging. Thrombus involving veins distal to the popliteal vein was classified as distal DVT, whereas involvement of the popliteal vein and proximal was classified as proximal DVT. Results: We could demonstrate that involvement of proximal segments (CEAP anatomic classification 1-9) occurred significantly more often in patients with recurrent DVT than in patients with the first DVT ( P < .001). The incidence of pulmonary embolism (PE) and the clinical symptoms of PE were equally distributed between patients with recurrent DVT and those with first DVT ( P > .05). Only one patient died as a consequence of PE in our patient sample. Conclusions: In our experience, patients with recurrent DVT have a higher frequency of proximal DVT. Nevertheless, the incidence of PE is similar in patients with recurrent and those with first DVT. (J Vasc Surg 2002;36:357-60.)