ABSTRACT
OBJECTIVE: The most frequent complication of deep venous thrombosis (DVT) is post-thrombotic syndrome (PTS). We recently showed inhibition of varicose vein development by atorvastatin and rosuvastatin. The aim of this study was to test the influence of lipid-lowering therapy with statins on PTS development. METHODS: All patients between January 2002 and June 2018 with diagnosed DVT were enrolled in this study and analyzed retrospectively. Documentation was performed using the standardized system M1 (CompuGroup Medical, Koblenz, Germany) throughout the observation period. Patients received therapeutic anticoagulation and compression stockings. In case of recurrent DVT, patients received lifelong therapeutic anticoagulation. All patients received clinical examination and duplex ultrasound evaluation 3 to 6 months after primary diagnosis and annually thereafter. RESULTS: A total of 579 patients with DVT were enrolled in this study. Of these patients, 414 (71%) developed PTS (337/414 [81%] presented with the mild version; mean Villalta score, 5.79). Risk factors for PTS development were recurrent DVT (P = .001) and malignant disease (P = .001). Protective factors were therapy with platelet aggregation inhibitors (P = .049) and lipid-lowering therapy with statins (P = .001). After multivariable analysis, the only risk factor was recurrent DVT (P = .001), and the only protective factor was lipid-lowering therapy (P = .001). CONCLUSIONS: Post-thrombotic changes might be reduced by lipid-lowering therapy.
Subject(s)
Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Postthrombotic Syndrome/prevention & control , Venous Thrombosis/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Female , Germany/epidemiology , Humans , Incidence , Male , Middle Aged , Platelet Aggregation Inhibitors/therapeutic use , Postthrombotic Syndrome/diagnostic imaging , Postthrombotic Syndrome/epidemiology , Prognosis , Protective Factors , Registries , Retrospective Studies , Risk Assessment , Risk Factors , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/epidemiology , Young AdultABSTRACT
OBJECTIVE: Popliteal vein aneurysms are associated with high risk for deep venous thrombosis (DVT) and pulmonary embolism. The goal of this study was to report treatment strategies for popliteal vein aneurysms and their outcome after long-term follow-up. METHODS: All patients between June 1993 and June 2018 with diagnosed popliteal vein aneurysm were enrolled in this study and analyzed retrospectively. They received regular surveillance alone or treatment. Patients were offered aneurysm resection or lifelong anticoagulation if they had aneurysm size of twice normal vein diameter. All patients received clinical examination and duplex ultrasound examination 3 to 6 months after operation or primary diagnosis and annually thereafter. RESULTS: A total of 39 patients (aneurysm size, mean 23.3 mm) were treated by either operation or anticoagulation (31/39 [79%]) or surveillance alone (8/39 [21%]). Patients with an aneurysm >20 mm in diameter had a significantly higher incidence of turbulent flow on duplex ultrasound examination with higher risk for development of DVT (P = .029). Of the 31 patients with a therapeutic approach, 29 (94%) preferred resection, whereas 2 (6%) patients were treated with lifelong anticoagulation and compression. Mean follow-up was 57.9 ± 12.5 months. CONCLUSIONS: According to these results, it seems that patients with large popliteal vein aneurysms experience DVT more frequently. Therefore, popliteal vein aneurysms >20 mm should be considered for surgical treatment or lifelong anticoagulation, depending on the patient's preference.
