Journal of vascular surgery. Venous and lymphatic disorders最新文献

{"title":"Rapid Post Exercise Venous Refilling Time is an Independent Contributor to Chronic Venous Insufficiency.","authors":"Hossam Elbenawi, Atefeh Ghorbanzadeh, David Liedl, Thom Rooke, Paul Wennberg, Robert McBane, Damon E Houghton","doi":"10.1016/j.jvsv.2025.102292","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102292","url":null,"abstract":"<p><strong>Background: </strong>Chronic venous insufficiency (CVI) results in complications such as pain, swelling, edema, skin changes, and ulcerations of the lower extremities. Valvular incompetence and venous obstruction are well-recognized contributors to CVI. Post-exercise venous refilling time (P-EVRT), the time to refill veins after calf muscle contractions during venous plethysmography study, is an understudied contributor to CVI.</p><p><strong>Methods and results: </strong>In this cross-sectional study of 4,755 patients who were evaluated with venous air plethysmography, 9,510 lower limbs were categorized based on Post-Exercise Venous Refilling Time (P-EVRT) into two groups: rapid (< 20 seconds; n=5,256) and normal (n=4,254). Rapid P-EVRT was associated with higher mean CEAP scores (3.2 vs 2.5, p<0.001) and a higher prevalence of active/prior ulcers (11.6 vs 4.1%, p<0.001). Univariable analysis showed that age, male sex, the severity of incompetence, obstruction, calf pump function (CPF), and rapid P-EVRT were all significantly associated with active/prior ulcers. After multivariable adjustment for these significant factors, rapid P-EVRT was an independent contributor to active/prior ulcers (OR 1.44, 95% CI 1.17-1.77). Among limbs without other venous pathology by plethysmography (incompetence, obstruction, reduced CPF), rapid P-EVRT remained significantly associated with higher mean CEAP scores (p<0.001) and a higher prevalence of venous ulcers than limbs with normal P-EVRT (5.7 vs 2.7%, p=0.001).</p><p><strong>Conclusions: </strong>In this large contemporary study using venous air plethysmography, we demonstrate that rapid post-exercise venous refilling is an important and unique venous physiologic parameter that informs our understanding of the clinical severity of CVI.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102292"},"PeriodicalIF":2.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-Assisted Left Renal Vein Transposition with Distal Gonadal Vein Anastomosis: A Novel Technique for Dual Venous Drainage in Nutcracker Syndrome.","authors":"JinBin Xu, Sam Un Cheong, GengGuo Deng, Zifeng Xu, ZhanSen Huang, Yuedian Ye, Hua Wang, Weihao Liu, Xiaoming Li, Jiang Li, Qunxiong Huang, Tengcheng Li, Jinming Di","doi":"10.1016/j.jvsv.2025.102289","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102289","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and outcomes of a novel robotic-assisted laparoscopic technique-Di's II robotic-assisted left renal vein (LRV) transposition with distal gonadal vein anastomosis-creating dual venous drainage for treating nutcracker syndrome (NCS).</p><p><strong>Methods: </strong>Between December 2023 and October 2024, three male patients (median age: 14 years) with NCS underwent robotic-assisted LRV transposition using the Di's II technique. Key procedural innovations included selective occlusion of the infrarenal inferior vena cava (IVC) and LRV without right renal vein clamping, combined with distal gonadal vein anastomosis to enhance venous drainage. Operative parameters, including anastomosis time, blood loss, and postoperative outcomes, were analyzed retrospectively.</p><p><strong>Results: </strong>All procedures were successfully completed robotically. Median total operative time was 145 minutes (range: 135-160), with LRV and gonadal vein anastomosis times of 25 minutes (range: 24-27). Median blood loss was 40 mL (range: 30-50). Postoperative imaging confirmed resolution of LRV compression, with pressure gradients reduced to ≤2.8 mmHg. Symptoms (hematuria, proteinuria, varicocele) resolved within six months, and no perioperative complications occurred during follow-up.</p><p><strong>Conclusions: </strong>The Di's II technique represents a safe and effective minimally invasive approach for NCS, combining robotic precision with dual venous drainage to alleviate LRV hypertension and pelvic congestion. Preliminary outcomes demonstrate technical feasibility, reduced ischemia risk, and symptom resolution, supporting further validation in larger cohorts.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102289"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Venous Tumor Thrombectomy in Renal Cell Carcinoma.","authors":"Sang Ah Lee, Hyeyeon Jang, Youngjin Han, Yong-Pil Cho, Jun Gyo Gwon","doi":"10.1016/j.jvsv.2025.102290","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102290","url":null,"abstract":"<p><strong>Objective: </strong>Renal cell carcinoma (RCC) has a unique feature in which tumor thrombus extends through the vein into the inferior vena cava (IVC). RCC with venous tumor thrombus is classified based on the level of thrombus. The standard treatment involves a combination of radical nephrectomy and tumor thrombectomy, despite the technical challenges associated with this approach. We aimed to evaluate the clinical outcomes based on the tumor thrombus level.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who underwent tumor resection and thrombectomy for RCC with venous tumor thrombus at a single center between January 2001 and December 2022. Tumor thrombus levels were classified into four levels (I-IV) according to the Mayo Clinic grading system, and patients were grouped based on the hepatic vein level: levels 0, I, and II were categorized as Group 1, while levels III and IV were categorized as Group 2. Survival outcomes were compared between the two groups using the Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>A total of 287 RCC patients with venous tumor thrombus who underwent tumor resection and thrombectomy were identified. The distribution of patients according to the tumor thrombus level was as follows: 84 patients had level 0 thrombus, 71 had level I, 85 had level II, 19 had level III, and 28 had level IV. This results in 240 patients in group 1 (levels 0, I, II) and 47 patients in group 2 (levels III, IV). The five-year survival rates were 46.7% for group 1 and 53.2% for group 2. The Kaplan-Meier survival analysis showed no significant difference in five-year overall survival between the two groups (p=0.75). However, patients in group 2 had a significantly longer postoperative hospital stay (21.43 ± 23.09 days) compared to group 1 (10.63 ± 6.31 days; p=0.004).</p><p><strong>Conclusions: </strong>Tumor thrombus level is not a significant prognostic factor in RCC. Aggressive surgical removal should be considered, even for thrombus extending beyond the hepatic vein, given the acceptable prognosis.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102290"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Renal Vein Thrombosis with Nutcracker Syndrome.","authors":"Xin Wei Zhou, Dong Zhe Chai, Hua Yi Zhang","doi":"10.1016/j.jvsv.2025.102288","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102288","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102288"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pigmentation after Foam or Cryo-Laser Cryo-Sclerotherapy for lower limb reticular veins: A within-patient trial.","authors":"Anelise Rodrigues, Juliana Puggina, Viviane Santana da Silva, Camilla Moreira Ribeiro, Fabrício Rodrigues Santiago, Samantha Neves, Gabriel Henrique Simoni, Maria Fernanda Portugal, Eduardo Ramacciotti","doi":"10.1016/j.jvsv.2025.102285","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102285","url":null,"abstract":"<p><strong>Importance: </strong>Skin hyperpigmentation is a common complication after leg vein sclerotherapy and a primary concern for patients with cosmetic complaints.</p><p><strong>Objective: </strong>To determine if Cryo-Laser Cryo-Sclerotherapy technique (CLaCS) presents a lower incidence and intensity pigmentation after procedure compared to 0.5% polidocanol foam sclerotherapy, 60 days after a single treatment of reticular veins.</p><p><strong>Design: </strong>Open-label, prospective, within-patient, randomized, active controlled, safety trial with blind evaluators. Interventions from August through September 2021, with a two-month follow-up.</p><p><strong>Setting: </strong>Interventions were performed in a private clinic.</p><p><strong>Participants: </strong>Eligible patients were volunteers over 18 years old, with aesthetic discomfort related to bilateral lower limb reticular veins, similar length, and distribution, with veins' internal diameter up to 2.2mm in B-mode ultrasound.</p><p><strong>Interventions: </strong>Patients underwent consecutive CLaCS treatment in one limb and 0.5% polidocanol foam in the contralateral limb on the same day.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the presence of post-procedure pigmentation in treated areas 60 days after a single treatment, determined through photo evaluation and objective measurement of skin color dissimilarity between the treated area and the adjacent skin, using a precision colorimeter. Patients' aesthetic satisfaction improvement, vein diameter reduction, and minor/major adverse events were also assessed.</p><p><strong>Results: </strong>Twenty-three women (46 limbs) were treated, and two were lost to follow-up. No significant statistical difference in the number of limbs that developed post-treatment pigmentation was found for both photos (7 CLaCS versus 5 foam p=0.8906) and colorimetric (9 CLaCS versus 13 foam p=0,1445) evaluations. The CLaCS group had significantly lower intensity of pigmentation in colorimetry (mean ΔE of 1.30 for CLaCS versus 1.44 for foam, p=0.02735). No significant difference in veins' diameter reduction was found. Both groups presented substantial improvement in patients' satisfaction with their leg appearance.</p><p><strong>Conclusions and relevance: </strong>Although no statistical difference was found regarding the number of limbs that developed hypercromia after treatment of the reticular veins, CLaCS resulted in a lower intensity of skin color dissimilarity, less microthrombi formation and lower volume of sclerosant needed, without difference in diameter reduction rates, compared to polidocanol foam sclerotherapy. No major adverse events were reported.</p><p><strong>Trial registration: </strong>ReBEC: RBR-88mcd4c https://ensaiosclinicos.gov.br/rg/RBR-88mcd4c UTN U1111-1265-8900.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102285"},"PeriodicalIF":2.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal ultrasound approach for diagnosing pelvic venous disorders.","authors":"Francine Freitas Fernandes, Joana Storino, Fanilda Souto Barros, Manuella Barreto Silva, Nathalia Cardoso Oliveira, Isabela Rodrigues Tavares","doi":"10.1016/j.jvsv.2025.102286","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102286","url":null,"abstract":"<p><p>This article presents a detailed, step-by-step protocol for performing transvaginal ultrasound (TVUS) to assess the pelvic veins, emphasizing its importance in the diagnosis of pelvic venous disorders (PeVD). The protocol outlines anatomical landmarks, scanning techniques, and key ultrasound findings associated with PeVD. It also provides practical recommendations for optimizing image acquisition and interpretation. OVERVIEW: TVUS provides enhanced visualization of pelvic venous structures, with a particular emphasis on the pelvic venous plexuses, tributaries of the internal iliac vein, and gonadal veins. This protocol is designed to assist practitioners in the accurate assessment of PeVD by guiding the evaluation of the periuterine, perivaginal, gonadal, and iliac veins. It also includes techniques for identifying venous reflux and post-thrombotic changes. The advantages, limitations, and specific considerations for obtaining and interpreting TVUS images are also discussed. CONCLUSION: The integration of this protocol enables clinicians to improve the diagnostic accuracy of PeVD through a systematic and standardized approach to TVUS. In addition, promoting interdisciplinary awareness and use of TVUS in the assessment of PeVD may significantly improve patient management outcomes.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102286"},"PeriodicalIF":2.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors for Complete Recovery of Post-thrombotic Syndrome 6 Months after Venous Recanalization.","authors":"Lina Khider, Costantino Del Giudice, Nicolas Gendron, Chloé Gobert, Benjamin Planquette, Marc Al Ahmar, Guillaume Goudot, Emmanuel Messas, Marc Sapoval, Tristan Mirault","doi":"10.1016/j.jvsv.2025.102287","DOIUrl":"https://doi.org/10.1016/j.jvsv.2025.102287","url":null,"abstract":"<p><strong>Objective: </strong>Endovascular recanalization is considered for severely symptomatic patients with post-thrombotic syndrome (PTS) to alleviate symptoms. However, data on complete recovery and its predictors remain limited. This study aimed to assess persistent PTS six months after venous recanalization and identify predictive factors.</p><p><strong>Design: </strong>Single-center retrospective outcome-oriented cohort study.</p><p><strong>Methods: </strong>We reviewed electronic medical records of patients referred for endovascular venous recanalization between January 1, 2015, and September 30, 2019. Inclusion criteria were PTS defined by a Villalta score ≥ 5 or a leg ulcer at least six months after a deep vein thrombosis (DVT) episode. Complete PTS recovery was defined as a Villalta score < 5.</p><p><strong>Results: </strong>Sixty-seven patients (median age: 40 years [IQR 32-51], 78% women, 18% obese) were included. The initial Villalta score was 10 [IQR 7-14]. At six months, primary and secondary patency rates were 75% and 81%, respectively. Complete recovery was observed in 67% of patients. Multivariate analysis identified the initial Villalta score (OR 1.36, 95% CI 1.12-1.65, p = .002) and femoral vein obstruction (OR 3.79, 95% CI 1.06-13.61, p = .041) as predictors of persistent PTS, whereas long-term anticoagulation was not significant.</p><p><strong>Conclusion: </strong>Endovascular recanalization achieved PTS resolution in two-thirds of patients at six months, particularly in those with a low initial Villalta score and no femoral vein obstruction. A risk score incorporating these factors may aid clinicians in patient counseling regarding the expected benefits of the procedure.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102287"},"PeriodicalIF":2.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of sirolimus in the treatment of venous malformations: A meta-analysis of prospective studies.","authors":"Guoyong Wang, Wei Lu, Yingjie Zhu, Chaonan Wang, Xiaonan Yang","doi":"10.1016/j.jvsv.2025.102284","DOIUrl":"10.1016/j.jvsv.2025.102284","url":null,"abstract":"<p><strong>Background: </strong>Venous malformations are prevalent vascular anomalies. Recent clinical studies have explored the use of sirolimus for these conditions, particularly in patients who are not candidates for, or have shown limited response to, traditional treatments such as sclerotherapy and surgery. This meta-analysis systematically evaluates the efficacy and safety of sirolimus in treating venous malformations.</p><p><strong>Methods: </strong>We conducted searches in PubMed, Cochrane Library, Web of Science, and the Cochrane Database of Systematic Reviews until August 10, 2024. The quality of the included prospective studies (including both randomized and single-arm pre-post trials) was assessed using the Cochrane risk of bias tool. Statistical analyses were performed with Review Manager (Version 5.4).</p><p><strong>Results: </strong>Our analysis included eight prospective studies involving 74 patients. Primary outcomes measured changes in the volume and size of the malformations. Secondary outcomes assessed were functional disability scores, hemoglobin levels, coagulation indices, transfusion requirements, patient quality of life, and radiologic responses. Sirolimus demonstrated significant therapeutic benefits, with an odds ratio of 0.02 (95% confidence interval, 0.00-0.08) across six studies evaluating dichotomous variables. Results for continuous variables were consistent. Sirolimus showed safety in short-to medium-term use, with reversible mild to moderate side effects such as oral ulcers and liver function abnormalities. No severe adverse events (grade 3-5) were reported.</p><p><strong>Conclusions: </strong>Sirolimus is effective and safe for treating venous malformations, especially in patients unresponsive to conventional therapies. Future studies should explore long-term effects, optimal dosages, and administration techniques.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102284"},"PeriodicalIF":2.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of inferior vena cava filter retrieval in a population-based Canadian cohort","authors":"Serena Ip BSc, BHSc ,&nbsp;Konrad Salata MD, PhD ,&nbsp;Jin Luo MSc ,&nbsp;Charles de Mestral MDCM, PhD ,&nbsp;Graham Roche-Nagle MD, MBA","doi":"10.1016/j.jvsv.2025.102283","DOIUrl":"10.1016/j.jvsv.2025.102283","url":null,"abstract":"<div><h3>Background</h3><div>The objective of this study was to determine the predictors of inferior vena cava (IVC) filter retrieval in a contemporary North American cohort of patients who received an IVC filter.</div></div><div><h3>Methods</h3><div>A retrospective population-based cohort study was conducted using Ontario administrative health data. Physician service fee codes were used to identify all adults with an IVC filter placement from January 1, 2010, to December 31, 2019. The cumulative incidence of filter retrieval over time was calculated, accounting for death as a competing risk. Multivariable sub-distribution hazard regression models were constructed to quantify the association between covariates and the likelihood of filter retrieval.</div></div><div><h3>Results</h3><div>A total of 5617 people received an IVC filter during the study period. Median follow-up was 1.8 years (interquartile range, 0.2-5.4 years). The probability of filter retrieval plateaued under 40% with most retrievals (96%; n = 2049 of 2135) occurring within 1 year of placement. Filter placement in a teaching hospital (hazard ratio, 1.85; 95% confidence interval, 1.60-2.02), and placement after 2016 were associated with a greater likelihood of filter retrieval. Older age and greater comorbidity were associated with a lower likelihood of filter retrieval.</div></div><div><h3>Conclusions</h3><div>In this population-based study of IVC filter retrieval, less than 40% of filters were retrieved, mostly within 1 year of insertion. Better coordination and standardization of services responsible for follow-up of patients with IVC filters are needed.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 6","pages":"Article 102283"},"PeriodicalIF":2.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical outcomes among patients with proximal versus isolated distal deep vein thrombosis: A systematic review and meta-analysis","authors":"Siyi Zhang BS,&nbsp;Can Shi PhD,&nbsp;Xia Wang MS,&nbsp;Huilin Xu BS,&nbsp;Ziwei Liu BS,&nbsp;Songhua Chen BS,&nbsp;Tian Wu PhD,&nbsp;Ren Guo PhD","doi":"10.1016/j.jvsv.2025.102281","DOIUrl":"10.1016/j.jvsv.2025.102281","url":null,"abstract":"<div><h3>Objective</h3><div>Deep vein thrombosis (DVT) ranks among the top five most prevalent vascular diseases globally and encompasses proximal deep vein thrombosis (PDVT) and isolated distal deep vein thrombosis (IDDVT). IDDVT affects approximately 50% to 65% of patients with DVT. However, due to a lack of prospective studies and conflicting perspectives on its potential to lead to pulmonary embolism (PE), the management of IDDVT remains contentious. Therefore, this meta-analysis was conducted to compare the clinical outcomes of PDVT and IDDVT.</div></div><div><h3>Method</h3><div>We searched studies including proximal and isolated distal thrombotic outcomes in the electronic databases PubMed, EMBASE, Cochrane, and Web of Science. The literature was then screened based on title, abstract, and full text to exclude those that did not meet the criteria. A total of 21 cohort and randomized controlled studies were included.</div></div><div><h3>Results</h3><div>Compared with IDDVT, PDVT was associated with higher rates in recurrent vein thromboembolism (VTE) (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.35-1.93; <em>P</em> &lt; .001), PE (OR, 1.52; 95% CI, 1.16-1.99; <em>P</em> = .002), major bleeding (OR, 1.95; 95% CI, 1.23-3.09; <em>P</em> = .005), and all-cause mortality (OR, 2.02; 95% CI, 1.19-3.44; <em>P</em> = .009). However, no significant differences were found in the rates of any bleeding (OR, 1.57; 95% CI, 0.96-2.58; <em>P</em> = .070) and nonmajor bleeding (OR, 1.03; 95% CI, 0.69-1.54; <em>P</em> = .88).</div></div><div><h3>Conclusions</h3><div>Compared with patients with PDVT, patients with IDDVT may have lower rates of recurrent VTE, PE, major bleeding events, and all-cause mortality, demonstrating safer clinical outcomes.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 6","pages":"Article 102281"},"PeriodicalIF":2.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}