Venous thrombosis at unusual site in women

Abstract

Several sex-related differences in the incidence rate, clinical presentation and outcomes of VTE were recently investigated. Gender-related risk factors, such as the use of oral contraceptives (OC) and pregnancy, in particular in women with a thrombophilic state, are associated with an increased risk of venous thromboembolism (VTE). In the middle age population, many studies report a higher incidence of VTE in men than in women, but the incidence rate of pulmonary embolism (PE) secondary to deep vein thrombosis (DVT) seems to be higher in women than in men, especially when older than 50 years. Finally, a recent meta-analysis showed that men have about a 50% higher risk than women of recurrent VTE, regardless of the site of the first DVT or the risk factors associated with the index event. The most common manifestations of VTE are represented by DVT of the lower limbs and PE, but VTE can potentially involve any section of the venous system, including cerebral veins, abdominal and pelvic veins, and the veins of the upper limbs. The scope of this article is to provide an overview of VTE in unusual sites, with particular focus on the epidemiology, on gender specific risk factors, and on clinical outcome in women.