Table of Contents
Thrombosis
Volume 2013, Article ID 247913, 9 pages
http://dx.doi.org/10.1155/2013/247913
Research Article

A Systematic Review of the Utility of Residual Vein Obstruction Studies in Primary and Secondary Venous Thrombosis

1Division of Hematology, Montefiore Medical Center and the Albert Einstein College of Medicine, 3411 Wayne Avenue, Ground Floor, Bronx, NY 10467, USA
2Department of Medicine, Montefiore Medical Center and the Albert Einstein College of Medicine, 3411 Wayne Avenue, Ground Floor, Bronx, NY 10467, USA

Received 20 June 2013; Revised 18 September 2013; Accepted 25 September 2013

Academic Editor: Domenico Prisco

Copyright © 2013 Murali Janakiram et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Residual vein obstruction (RVO), the persistence of venous thrombosis with time and often after anticoagulation, may indicate a systemic prothrombotic condition. Prior studies have shown varying efficacy in using RVO as a risk factor for future venous thromboembolic (VTE) recurrence. Methods. To assess whether positive RVO imaging predicts recurrent VTE events, we performed a meta-analysis on studies in which patients with documented VTEs, anticoagulated for a minimum of 4 weeks, had repeat sonography to assess RVO and were subsequently followed for recurrent events. Results. Thirteen studies met inclusion criteria: 3531 patient VTE events with 3474 evaluable results were analyzed. The presence of RVO was associated with recurrence in all VTE (OR 1.93; 95% CI: 1.29, 2.89) and secondary VTE (OR 2.78; 95% CI: 1.41, 5.5) but not for primary VTE (OR 1.35; 95% CI: 0.87, 2.08). When cancer patients were eliminated from the secondary VTE group, there was no longer a significant association of RVO with VTE recurrence (OR 1.73; 95% CI: 0.81, 3.67) while in the subset of cancer patients, presence of RVO was associated with an increase in VTE recurrence risk (OR 5.14; 95% CI: 1.59, 16.65, ). Conclusions. We conclude that the presence of RVO is associated with recurrence in secondary VTE but not in primary VTE and that association may be driven by the subset with cancer.