Calf DVT treatment reduces pulmonary embolism risk
MedWire News: Giving anticoagulation for calf deep venous thrombosis (CDVT) significantly reduces rates of pulmonary embolism (PE) and clot propagation compared with no treatment, results of a meta-analysis show.
Randall De Martino (Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA) revealed the findings at the Society for Vascular Surgery's 65th Vascular Annual Meeting in Chicago, Illinois, USA.
De Martino and colleagues conducted a systematic review and meta-analysis to determine the impact of anticoagulation on rates of PE, clot propagation, post-thrombotic syndrome, mortality, and bleeding in patients with CDVT.
They identified eight studies (two randomized controlled trials and six cohort studies) from the scientific literature that included 504 patients with confirmed CDVT diagnosed by ultrasound or venogram. All of the studies compared patients treated with anticoagulation (vitamin K antagonist or heparin; n=126) for 30 or more days with controls who did not receive anticoagulation (n=378), and had a follow-up period of at least 1 month.
De Martino reported that patients who received anticoagulation were 88% less likely to have PE and 71% less likely to have clot propagation than those who did not receive this treatment.
Variation among the studies meant that results for bleeding complications and mortality could not be pooled, but favored the control and anticoagulation groups, respectively. No data on post-thrombotic syndrome were available.
De Martino noted that the review and meta-analysis was limited by the poor quality of the studies in the literature.
He said that the results suggest that anticoagulation for CDVT may decrease clinically important outcomes such as PE and clot propagation, but "treatment-related complications have been poorly documented.
"This makes determining the benefits and harms of treatment difficult."
He concluded: "More rigorous studies can improve the quality evidence for treatment for CDVT."
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By Laura Dean