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Thromboembolism May Recur With Residual Vein Obstruction

But no increased risk seen in unprovoked DVT subgroup at end of anticoagulant therapy

THURSDAY, March 24 (HealthDay News) -- In patients with provoked or unprovoked deep vein thrombosis (DVT), residual vein obstruction (RVO) is associated with a slight increase in the risk of recurrent venous thromboembolism (VTE) but does not seem to predict recurrent VTE in patients with unprovoked DVT following discontinuation of anticoagulation therapy, according to a meta-analysis published online March 7 in the Journal of Thrombosis and Haemostasis.

Marc Carrier, M.D., from the University of Ottawa in Canada, and colleagues determined whether RVO was associated with an increased risk of recurrent VTE in 4,022 patients with DVT. Fourteen studies were identified after a systematic literature search to include patients with DVT who were evaluated for RVO using compression ultrasonography.

The investigators found that, in patients with unprovoked DVT who stopped oral anticoagulation therapy at the time of RVO assessment, the presence of RVO was not associated with an increased risk of recurrent VTE (odds ratio [OR], 1.24; 95 percent confidence interval [CI], 0.9 to 1.7). However, there was a significant association between RVO and recurrent VTE in patients with provoked or unprovoked DVT (OR, 1.5; 95 percent CI, 1.1 to 2.0).

"RVO is associated with a modest increased risk of recurrent VTE in all patients with DVT (provoked and unprovoked)," the authors write. "RVO does not seem to be an independent predictor of recurrent VTE in patients with unprovoked DVT following discontinuation of anticoagulation and should not be currently used routinely to assess length of anticoagulation in these patients."

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