PB0922 - Recurrence and Post-Thrombotic Syndrome and its Association with Residual Vein Thrombus and Gray Scale Median Analysis

Background: Deep vein thrombosis (DVT) presents a high incidence rate and the main complications are pulmonary embolism, recurrence and post-thrombotic syndrome (PTS).

Aims: To evaluate the relationship between residual vein thrombus (RVT) and Gray Scale Median (GSM) analysis and PTS and DVT recurrence

Methods: Clinical history, comorbidities, age, weight and height, habits, specific details about the DVT event- such as date, time from symptoms to diagnosis, risk factors, anticoagulation, and PTS evaluated by Villalta scale were analysed. Doppler ultrasound (US) to visualize the RVT, percentage of vessel occlusion measured through the image evaluation including vessel and the thrombi size, and GSM analysis of RVT were performed. This stufy was approved by Ethics Research Committee of Unicamp CAAE number: 38487114.2.0000.5404

Results: Two-hundred forty-nine patients were included and divided according to the presence or absence of RVT. The patients who presented RVT (57.8%) showed a high incidence of recurrence (34.0% vs 21.9%, p=0.087) but not statistically significant. There were no differences in GSM values (median 23 vs 21 p=0.5408) between those with or without recurrence. There was no difference regarding presence of PTS and RVT. However, decreased GSM values (median 17.50) were observed in those patients with RVT classified as moderate/severe PTS when compared to mild or absent PTS (median 23) (p=0.0445). Interestingly, the presence of a hypoechoic RVT was detected even a long time after the acute thrombotic event. There was no relation between PTS or DVT recurrence and percentage of occlusion or number of proximal vessels committed.

Conclusion(s): Our results suggest that RVT analysis by GSM showed a hypoechoic thrombus that represent the persistence of a nonorganized thrombi in the vessel lumen, could contribute to more severe PTS development.