Program: Oral and Poster Abstracts
Type: Oral
Session: 331. Pathophysiology of Thrombosis: Prediction of VTE and Complications
Objective: To determine the impact of anatomical characteristics of iSVT on the long-term risk of VTE recurrence.
Methods: Using data from the The OPTIMEV (OPTimisation de l’Interrogatoire dans l’_evaluation du risque throMbo-Embolique Veineux) study, a prospective, observational, multicenter study, we assessed at 3 years in patients recruited for an objectively confirmed iSVT i) cumulative rates of DVT, PE and SVT recurrences using the Kaplan-Meier method; and ii) anatomical predictors of VTE recurrence (SVT involving the sapheno-femoral junction (i.e. ≤3 cm), SVT of the trunk of the great saphenous vein, bilateral SVT, SVT occurring in a varicose vein (i.e. C≥2 according to CEAP classification) using a Cox multivariable model adjusted for age, sex, cancer and personal history of VTE. At baseline, all patients with SVT underwent a complete bilateral swhole leg ultrasound to exclude concurrent DVT and during follow-up, all suspected VTE recurrences were confirmed/ruled out with objective tests. All recurrences were centrally adjudicated by the study’s expert committee.
Results: Among the 479 recruited patients with iSVT, 12.5% (n=60) had a thrombotic recurrence during the 3 years of follow-up. Cumulative rates of recurrence as a PE, DVT and iSVT were 1.9%, 4.8% and 5.8%, respectively. In multivariate analysis, a thrombus involving the sapheno-femoral junction at baseline independently increased the risk of VTE recurrence (HR=3.34 [1.5-7.2]). Presence of varicose veins also increased the risk but this result did not reach statistical significance (HR=1.8 [0.9 – 3.9], p=0.11).
Conclusion: In an unselected population of patients with iSVT, long-term risk of VTE recurrence is substantial. Involvement of the sapheno-femoral junction is a strong independent predictor of VTE during the subsequent 3 years. Our results suggest the need for more aggressive management and follow-up of patients with iSVT exhibiting this anatomical characteristic.
Disclosures: Galanaud: Daichi: Membership on an entity’s Board of Directors or advisory committees , Research Funding ; bayer: Membership on an entity’s Board of Directors or advisory committees , Research Funding . Sevestre: bayer: Membership on an entity’s Board of Directors or advisory committees , Research Funding ; Daichi: Membership on an entity’s Board of Directors or advisory committees , Research Funding . Pernod: pfizer: Consultancy ; leo: Consultancy ; bristol meyers: Consultancy ; Daichi: Consultancy ; bayer: Consultancy . Brisot: bayer: Membership on an entity’s Board of Directors or advisory committees ; daichi: Membership on an entity’s Board of Directors or advisory committees . Quéré: 3-M: Research Funding ; thuasne: Research Funding ; aspen: Research Funding ; daichi: Membership on an entity’s Board of Directors or advisory committees ; bayer: Membership on an entity’s Board of Directors or advisory committees ; leo: Membership on an entity’s Board of Directors or advisory committees .
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