Differences in limb, age and sex of Chinese deep vein thrombosis patients.

OBJECTIVE: Recently, the differences in age or sex of deep vein thrombosis (DVT) patients have been widely debated. However, close analyses of the differences in limb, age and sex of Chinese DVT patients have been scarcely reported. The purpose of this research is to study the differences in limb, age and sex of DVT patients. METHODS: A total of 783 consecutive DVT patients were retrospectively reviewed. Patients with an acute presentation of DVT were diagnosed by means of compression ultrasonography or venography. Clinical characteristics and provoked risk factors were analyzed. RESULTS: There were three frequency peaks including two smaller peaks at age 20-24 and 70-74 years, and the largest peak at age 45-59 years. The most significant risk factors affecting different age groups were as follows: pregnancy/puerperium for age ≤ 39; fracture and hysterectomy for age 40-64; fracture and malignancy for age ≥ 65. DVT frequency rate provoked by malignancy was higher in right DVT than left DVT (15.8% vs. 4.6%; p < 0.001). Left DVT was more common than right DVT (582 vs. 158). Left DVT tended to occur in females (male:female, 40.5%:59.5%), and right DVT in males (male:female, 74.7%:25.3%). DVT provoked by pregnancy/puerperium (56/63, 88.9%) or hysterectomy (27/30, 90.0%) was mostly located in left limb. CONCLUSION: It is necessary to pay more attention to thromboprophylaxis for patients with the risk factors of pregnancy/puerperium, hysterectomy, fracture and malignancy, especially those over the age of 65. And further research into the cause of limb, age and sex differences in DVT occurrence is needed.

Compression of left common iliac vein is independently associated with left-sided deep vein thrombosis.

OBJECTIVE: Left-sided lower extremity deep vein thrombosis (DVT) is more common than right-sided DVT. This difference was found to be caused by the compression of the left iliac common vein (LCIV). To evaluate and compare LCIV compression in unilateral DVT patients and the normal population and investigate the association of LCIV compression with the risk of left-sided DVT. METHODS: A retrospective analysis of records and computed tomography imaging was conducted in 19 right DVT, 60 left DVT, and 218 control subjects. The influences of LCIV diameter and stenosis on the risk of left DVT were investigated using logistic regression analysis. RESULTS: In control subjects, 51.8% had greater than 50% compression of the LCIV, and 24.3% had greater than 70% compression. Mean LCIV diameter was smaller in left DVT (2.39 mm) than in right DVT (6.18 mm) or normal control (5.39 mm). Mean LCIV stenosis was higher in left DVT (77.57%) than in right DVT (38.01%) or normal control (49.31%). The odds of left DVT increased by a factor of 2.69 for each millimeter decrease in LCIV diameter and 2.78 for each 10% increase in LCIV stenosis. With LCIV stenosis >75%, the risk of left DVT was associated with an 11-fold increase, and with LCIV diameter <2.5 mm, the risk was associated with a 13.5-fold increase. Unprovoked and provoked left DVT patients had similar LCIV compression, and left DVT patients had more significant LCIV compression than right DVT patients. CONCLUSIONS: LCIV compression was a normal anatomical pattern with an increased risk of left DVT. LCIV compression might be the essential and prereqisite factor for left DVT. Patients with severe LCIV compression should receive more emphasis on left DVT prophylaxis because they are the high-risk population of left DVT.