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Poster Networking

Venous Thromboembolism

PB0381 - Anticoagulant treatment for isolated distal deep vein thrombosis: A systematic review and meta-analysis

Sunday, June 23, 2024
13:45 – 14:45 ICT
Room: Exhibition Hall

    Co-Author(s)

  • MG

    Matteo Guarascio

    MD
    Interna Medicine Unit, Vito Fazzi Hospital, Lecce
    Lecce, Puglia, Italy

  • EV

    Emanuele Valeriani

    PhD Student
    Sapienza University of Rome
    Rome, Lazio, Italy

  • LG

    Laura Girardi

    PhD Student
    Department of Medicine and Surgery, Research Center on Thromboembolic Diseases and Antithrombotic Therapies, University of Insubria, Varese, Italy
    Varese, Lombardia, Italy

  • MC

    Matteo Candeloro

    MD, PhD
    Department of Innovative Technologies in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
    Chieti, Abruzzi, Italy

    • Presenting Author(s)

  • Walter Ageno, MD

    Professor
    University of Varese
    Bellinzona, Ticino, Switzerland

Background: The optimal therapeutic management for Isolated Distal Deep Vein Thrombosis (IDDVT), both in terms of the need for and duration of anticoagulation, remains uncertain.

Aims: The aim of our meta-analysis is to assess the efficacy and safety of anticoagulant therapy versus no therapy and of long-term (>6 weeks) versus short-term anticoagulant treatment in patients with IDDVT.

Methods: We performed a systematic search of MEDLINE, EMBASE, and Cochrane library since inception and up to October 2023 to identify all available randomized controlled trials (RCTs) and observational studies on anticoagulant therapy in IDDVT. The efficacy outcome was recurrent venous thromboembolism (VTE) (i.e., proximal extension, recurrence of deep vein thrombosis, and pulmonary embolism) while the safety outcome was major bleeding. Pooled relative risks (RRs) with corresponding 95% confidence interval (CI) were calculated in a random effect model.

Results: 26 (10 RCTs and 16 observational studies) out of 1858 studies met the inclusion criteria and were included in the analysis, for a total of 5078 patients. The rate of recurrent VTE was lower in patients who received either therapeutic or prophylactic anticoagulation compared to those who did not receive anticoagulation, (20 studies, 989 vs 1569 patients; RR 0.52; 95% CI, 0.31-0.88), without an increased risk of major bleeding (9 studies, 468 vs 533 patients; RR 0.66; 95% CI, 0.03-14.18). Similar results were obtained in patients who received long-term anticoagulant therapy compared to those who received short-term treatment (6 studies, 1158 vs 981 patients; RR for VTE 0.39; 95% CI, 0.17-0.92) without increasing major bleeding risk (6 studies, 1720 vs 1575 patients; RR 1.49; 95% CI, 0.25-8.95).

Conclusion(s): Anticoagulant therapy seems to reduce the incidence of recurrent VTE in patients with IDDVT without increasing the risk for major bleeding. Long-term anticoagulation (> 6 weeks) safely reduced recurrent VTE compared to short-term treatment.