Thrombosis UpdatePub Date : 2024-09-28DOI: 10.1016/j.tru.2024.100190
Eric Manderstedt , Christina Lind-Halldén , Christer Halldén , Johan Elf , Peter J. Svensson , Gunnar Engström , Olle Melander , Aris Baras , Luca A. Lotta , Bengt Zöller , for the Regeneron Genetics Center
{"title":"Tissue factor (F3) gene variants and thrombotic risk among middle-aged and older adults: A population-based cohort study","authors":"Eric Manderstedt , Christina Lind-Halldén , Christer Halldén , Johan Elf , Peter J. Svensson , Gunnar Engström , Olle Melander , Aris Baras , Luca A. Lotta , Bengt Zöller , for the Regeneron Genetics Center","doi":"10.1016/j.tru.2024.100190","DOIUrl":"10.1016/j.tru.2024.100190","url":null,"abstract":"<div><h3>Background</h3><div>Tissue factor (TF), encoded by the <em>F3</em> gene, is the main initiator of blood coagulation. The molecular epidemiology of the <em>F3</em> gene and the relation to venous thromboembolism (VTE) remains to be determined.</div></div><div><h3>Objectives</h3><div>The aim was to determine the molecular epidemiology and the importance of <em>F3</em> variants for incident VTE by analysis of the population-based MDC study (Malmö Diet and Cancer), consisting of unselected middle-aged and older individuals.</div></div><div><h3>Methods</h3><div>The exons of <em>F3</em> were analyzed in a total of 28,794 individuals from the MDC cohort, and of these, 2584 (9 %) were affected by VTE during follow‐up (1991–2018). Qualifying variants used in gene-collapsing analysis were defined as loss-of-function or non-benign (PolyPhen-2) missense variants with minor allele frequency less than 0.1 %.</div></div><div><h3>Results</h3><div>Exon sequencing of the <em>F3</em> gene identified 61 different variants, 3′ UTR variants (n = 5), 5′ UTR variants (n = 9) synonymous (n = 10), in frame insertion (n = 1), splice region variants (n = 2), missense (n = 33) or loss-of-function variants (n = 1). No associations between common <em>F3</em> gene variants and incident VTE were found. Seventeen rare variants were classified as qualifying and included in collapsing analysis (16 non-benign missense and 1 loss-of-function variants). The prevalence of <em>F3</em> qualifying variants was 0.14 %. Seven individuals with <em>F3</em> qualifying variants had VTE, while 34 individuals had no VTE. The adjusted VTE model was significant (hazard ratio = 2.1 [95 % confidence interval, 1.02–4.48], <em>P-value</em> = 0.045).</div></div><div><h3>Conclusions</h3><div>Qualifying <em>F3</em> gene variants are very rare, indicating a constrained gene. Rare but not common variation in the <em>F3</em> gene may be involved in VTE.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis UpdatePub Date : 2024-09-25DOI: 10.1016/j.tru.2024.100191
Francisco José Pelegrín Mateo , Teresa Quintanar Verdúguez , Dialina Brilhante , Asia Ferrández Arias , Alejandra Romano Cardozo , Eva Martínez de Castro , José Muñoz Langa , Elena Brozos Vázquez , María Vallamayor Delgado , Berta Obispo Portero , Enrique Gallardo , José Rubio Pérez , Isaura Fernández Pérez , Ignacio García Escobar , Silvia García Adrián , José Antonio Santiago Crespo , Lola Rodríguez-Nogueira , Gretel Benítez López , Paula Jimenez-Fonseca , Andrés Muñoz Martín
{"title":"Catheter – related thrombosis in cancer patients: Data from the registry of thrombosis and nEoplasia of SEOM (TESEO)","authors":"Francisco José Pelegrín Mateo , Teresa Quintanar Verdúguez , Dialina Brilhante , Asia Ferrández Arias , Alejandra Romano Cardozo , Eva Martínez de Castro , José Muñoz Langa , Elena Brozos Vázquez , María Vallamayor Delgado , Berta Obispo Portero , Enrique Gallardo , José Rubio Pérez , Isaura Fernández Pérez , Ignacio García Escobar , Silvia García Adrián , José Antonio Santiago Crespo , Lola Rodríguez-Nogueira , Gretel Benítez López , Paula Jimenez-Fonseca , Andrés Muñoz Martín","doi":"10.1016/j.tru.2024.100191","DOIUrl":"10.1016/j.tru.2024.100191","url":null,"abstract":"<div><h3>Background</h3><div>Catheter related thrombosis (CRT) is the most frequent non-infectious complication associated with central venous access devices (CVAD), with a reported incidence between 13 % and 66 % in symptomatic and asymptomatic patients, respectively, with several factors influencing its development.</div></div><div><h3>Methods</h3><div>CRT events recorded in TESEO, an international, multicentric, and prospective cancer-associated thrombosis registry were assessed. Descriptive analyses were conducted.</div></div><div><h3>Results</h3><div>Between July 2018 and December 2023, 2,567 patients were included in TESEO. Of these, 245 patients developed CRT and were included in this analysis. Mean age was 60.5 years (SD 12.3). Peripherally inserted central catheters (PICC) were present in 42.1%, totally implanted ports (PORT) in 40.9% while 17% had missing data. The most common reported comorbidities were arterial hypertension (28.6%) and dyslipidemia (28.2%). Other thromboembolism associated risk factors were present in ≤10% of patients.</div><div>Venous thromboembolism (VTE) related symptoms occurred in 70.2% of cases at presentation. Pulmonary embolism (PE) was present in 6.5%, being clinically suspected in 56.2% of cases. The diagnosis was mainly unilateral (81.3%) and 50% were central. Arterial and venous rethrombosis was present in 0.8% and 4.9% of cases respectively. Minor bleeding episodes occurred in 2.5% of cases, while major/clinically relevant episodes were present in 3.6%.</div></div><div><h3>Conclusions</h3><div>Usual VTE associated risk factors were infrequent in the TESEO registry population. CRT was symptomatic in most cases, with reduced complication rates after treatment.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Usability study of the qLabs® FIB: A new point-of-care system for functional fibrinogen testing","authors":"Maxence Hureau , Anne-Sophie Bouthors , Lucie Deroo , Anne-Sophie Baptiste , Agnès Le Gouez , Mathias Rossignol , Frederic J. Mercier , Agnès Rigouzzo","doi":"10.1016/j.tru.2024.100192","DOIUrl":"10.1016/j.tru.2024.100192","url":null,"abstract":"<div><h3>Background</h3><div>Identification of hypofibrinogenemia is particularly important in obstetrics since this predicts progression to severe Post-Partum Haemorrhage (PPH).</div></div><div><h3>Objectives</h3><div>To evaluate the usability of qLabs® FIB at the bedside of patients with PPH.</div></div><div><h3>Methods</h3><div>The qLabs® FIB test was performed using a drop of whole blood from a citrated laboratory tube sampled from each parturient with PPH >1 L by a trained user. A usability survey was completed by each clinician performing the test.</div></div><div><h3>Results</h3><div>During the evaluation, 101 qLabs® FIB tests were performed. One hundred completed surveys and 58 free comments were collected. Satisfaction was achieved in 84 % of tests. Usability in emergency setting, timeliness of results, and the results display were considered positive. The qLabs® FIB results were obtained in <3 min for concentrations below 3 g/L whilst the median time to paired laboratory results was 60 (20–120) minutes. The lower a patient's fibrinogen level, the faster the qLabs® FIB result.</div></div><div><h3>Conclusion</h3><div>The usability study was the first step in the validation process of the qLabs® FIB point of care device in obstetric settings.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis UpdatePub Date : 2024-09-01DOI: 10.1016/j.tru.2024.100188
Lucy A. Norris, Emmanouil S. Papadakis
{"title":"Nitrous oxide and VTE – no laughing matter","authors":"Lucy A. Norris, Emmanouil S. Papadakis","doi":"10.1016/j.tru.2024.100188","DOIUrl":"10.1016/j.tru.2024.100188","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572724000300/pdfft?md5=cca7db39af55ba8c3355b4e96dc70579&pid=1-s2.0-S2666572724000300-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis UpdatePub Date : 2024-08-13DOI: 10.1016/j.tru.2024.100187
João Gramaça , Ana Robalo Lopes, Marta Ganhão, Joana Gonçalves, Rita Gameiro, Isabel Fernandes, Adriano Baptista, Luísa Barbosa, Idília Pina
{"title":"Practical model for implementation of cancer-associated thrombosis prevention in the outpatient setting","authors":"João Gramaça , Ana Robalo Lopes, Marta Ganhão, Joana Gonçalves, Rita Gameiro, Isabel Fernandes, Adriano Baptista, Luísa Barbosa, Idília Pina","doi":"10.1016/j.tru.2024.100187","DOIUrl":"10.1016/j.tru.2024.100187","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572724000294/pdfft?md5=8ceba687e678dd8c5260c022af9b9069&pid=1-s2.0-S2666572724000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis UpdatePub Date : 2024-08-07DOI: 10.1016/j.tru.2024.100186
Paschalis Evangelidis , Eleni Gavriilaki , Dimitrios A. Tsakiris
{"title":"Thrombotic complications after hematopoietic stem cell transplantation and other cellular therapies","authors":"Paschalis Evangelidis , Eleni Gavriilaki , Dimitrios A. Tsakiris","doi":"10.1016/j.tru.2024.100186","DOIUrl":"10.1016/j.tru.2024.100186","url":null,"abstract":"<div><p>Hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor-T (CAR-T) immunotherapy are widely used for the management of hematological malignancies. HSCT can be complicated by endothelial injury syndromes, such as HSCT-thrombotic microangiopathy (HSCT-TMA) and sinusoidal obstructive syndrome/veno-occlusive disease (SOS/VOD), which are life-threatening. Moreover, venous thromboembolic events (VTEs) are common in HSCT recipients due to endothelial injury, use of central venous catheters, prolonged hospitalization, and the development of a procoagulant state. VTEs have also been reported post-CAR-T infusion. The management of thrombotic events in these patients is challenging, due to the high risk of bleeding that is present. CAR-T immunotherapy might be followed by toxicities, such as cytokine release syndrome (CRS) and immune effector cell-associated neuro-toxicity syndrome (ICANS). Endothelial dysfunction is implicated in the pathogenesis of these syndromes. Early recognition and management of the above complications are crucial for better patient outcomes.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572724000282/pdfft?md5=81a6ec543fa848b1f54eee965017eeb7&pid=1-s2.0-S2666572724000282-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis UpdatePub Date : 2024-07-24DOI: 10.1016/j.tru.2024.100185
Colton Jones , Abiodun Idowu , Elvis Obomanu , Raymond Smith , Karecia Byfield , Avinash Ramkissoon , Kevin Bryan Lo , Ryan Mayo
{"title":"Management of heparin-induced thrombocytopenia with factor xa inhibitors: A systematic review","authors":"Colton Jones , Abiodun Idowu , Elvis Obomanu , Raymond Smith , Karecia Byfield , Avinash Ramkissoon , Kevin Bryan Lo , Ryan Mayo","doi":"10.1016/j.tru.2024.100185","DOIUrl":"10.1016/j.tru.2024.100185","url":null,"abstract":"<div><p>Heparin-induced thrombocytopenia (HIT) is a rare but severe prothrombotic disorder that develops in patients exposed to heparin products. Diagnosis is associated with significant morbidity and mortality. The mainstay of treatment for HIT involves discontinuing all heparin products and administering non-heparin anticoagulants. Since the publication of the American Society of Hematology (ASH) guidelines in 2018, factor Xa inhibitors have become an attractive alternative. We systematically reviewed the literature to determine the efficacy and safety of factor Xa inhibitors in managing HIT. We included any case series, retrospective, or prospective study that evaluated the efficacy of factor Xa inhibitors. We searched PubMed, Ovid, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar from inception to September 2023. Three reviewers independently reviewed titles, abstracts, and full-text articles to determine eligibility using prespecified inclusion and exclusion criteria. Disagreements were resolved by discussion and consensus. Nine hundred sixty-four articles were screened against title and abstract, and 75 studies were selected for full-text review. Fifteen studies eventually met the inclusion criteria. Two hundred eighty-five patients across 15 studies were treated with factor Xa inhibitor. Across all study arms combined, HIT thrombosis-associated mortality was 0 % (n = 0), recurrent thrombosis was 4.56 % (n = 13), and major bleeding was 2.80 % (n = 8). Factor Xa inhibitors showed positive outcomes in HIT in terms of both safety and efficacy. Major limitation of this review is that the studies included are primarily retrospective and, thus, are subject to inherent limitations of observational study design. More randomized controlled trials (RCT) or prospective studies examining non-inferiority or superiority of transitioning to direct oral anticoagulant (DOAC) vs primary treatment with DOAC are needed.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572724000270/pdfft?md5=237ceb7c77231c44b9e5334492078af2&pid=1-s2.0-S2666572724000270-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis UpdatePub Date : 2024-07-23DOI: 10.1016/j.tru.2024.100184
Christine Joerres , Marta Patyjewicz , Melisa Cetin, Tadbir Bariana, Barbara Onen, Luke Hone, Jonathan Green, Deepa Tambe, Philip Dalby, Amy Keller, Alastair Noyce
{"title":"Assessing the prevalence of nitrous oxide usage in patients aged 35 years or under presenting with unprovoked VTE between 2021-2023","authors":"Christine Joerres , Marta Patyjewicz , Melisa Cetin, Tadbir Bariana, Barbara Onen, Luke Hone, Jonathan Green, Deepa Tambe, Philip Dalby, Amy Keller, Alastair Noyce","doi":"10.1016/j.tru.2024.100184","DOIUrl":"10.1016/j.tru.2024.100184","url":null,"abstract":"<div><h3>Background</h3><p>Nitrous oxide (N<sub>2</sub>O), often known as \"laughing gas,\" ranks as a widely used recreational drug among young people in the UK, with 3.9 % of young adults aged 16–24 reporting its use in 2021–2022. Besides its known neurological risks, there is emerging evidence linking N<sub>2</sub>O misuse to serious haematological issues, including arterial and venous thrombosis.</p></div><div><h3>Aims/objectives</h3><p>The project aimed to elucidate the prevalence of N<sub>2</sub>O usage in young adults (18–35 years) with unprovoked venous thromboembolism (VTE) between January 2021 and July 2023.</p></div><div><h3>Method</h3><p>Patient records from three East London emergency departments (ED), coded with a SNOMED code for VTE upon ED discharge between January 2021 and June 2023, were compiled using Qliksense. The data extracted from electronic patient records (EPR) encompassed demographics, confirmed cases of VTE at discharge, and history of N<sub>2</sub>O usage. Criteria for exclusion included age restrictions, established provoking factors for VTE, and unconfirmed reports of N<sub>2</sub>O use.</p></div><div><h3>Results</h3><p>We found 26 patients, out of which 8 patients (31 %) reported N<sub>2</sub>O use. Among these, a majority of 7 patients (88 %) reported regular N<sub>2</sub>O at the time of admission for VTE. Furthermore, 6 patients (75 %) reported regular N<sub>2</sub>O use for at least 12 months. The quantity of N<sub>2</sub>O usage varied widely, ranging from 7 to 210 (mean = 61.9, ∼495g) small canisters per week with each canister containing 8 g of N<sub>2</sub>O. The duration of N<sub>2</sub>O use varied significantly ranging from 7 to 59 months (mean = 29.25). This group of young adults (18–35; mean = 25) was 88 % male and 12 % female. The ethnic distribution among the cohort was 62 % Asian or Asian British, 25 % Black or Black British, and 12 % White. Stratified by the index of multiple deprivation 25 % were in quintile 1–2, 50 % were 3–4, 12 % were 5–6, and 12 % were in 7–8 range (0 % 9–10).</p></div><div><h3>Conclusion</h3><p>Healthcare providers, particularly those in Acute Medicine and EDs, should consider implementing VTE screening protocols for young adults aged 18–35 presenting to ED with reported N<sub>2</sub>O misuse and neurological problems. A thorough assessment of N<sub>2</sub>O usage patterns is essential, alongside the provision of culturally sensitive health education that addresses the unique needs of marginalised communities. Ongoing research is necessary to elucidate the pathophysiological pathways connecting N<sub>2</sub>O use to VTE incidents, particularly its link to increased homocysteine levels.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572724000269/pdfft?md5=42e5004e29bc328ff7eede285e540ca9&pid=1-s2.0-S2666572724000269-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis UpdatePub Date : 2024-07-08DOI: 10.1016/j.tru.2024.100183
Javier Soto Alsar , Roberto Jiménez Rodríguez , Ana Gutiérrez , Laura Ortega Morán , Andrés J. Muñoz Martín
{"title":"Update in venous thromboembolism in cancer: Lessons from multi-centre registries","authors":"Javier Soto Alsar , Roberto Jiménez Rodríguez , Ana Gutiérrez , Laura Ortega Morán , Andrés J. Muñoz Martín","doi":"10.1016/j.tru.2024.100183","DOIUrl":"https://doi.org/10.1016/j.tru.2024.100183","url":null,"abstract":"<div><p>Cancer-associated thrombosis is a common problem in cancer patients and one of the leading causes of death in this population. Randomised clinical trials have shown that both low-molecular-weight heparins and direct oral anticoagulants are the treatments of choice for cancer-associated thrombosis. Despite this, small sample sizes, poor representation of some patient subgroups and lack of information about real-world clinical situations are some of the limitations of randomised trials. To overcome these problems, registries have been established to collect real-world data from patients with cancer-associated thrombosis, offering new evidence and information to supplement the findings of randomised clinical trials. However, few registries have focused exclusively on cancer patients, and some have excluded various subgroups of patients. Additionally, data collection and processing are another major challenge in analysing registry results, where the emergence of artificial intelligence will play a fundamental role.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572724000257/pdfft?md5=4ba7087b1901b77ce711ff2009d4609c&pid=1-s2.0-S2666572724000257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141607372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis UpdatePub Date : 2024-07-01DOI: 10.1016/j.tru.2024.100182
Sara Ng, Cameron Brown, Farah Zarka, Aurélien Delluc, Marc Carrier
{"title":"The efficacy and safety of anticoagulation for the management of gonadal vein thrombosis: A systematic review and pooled analysis","authors":"Sara Ng, Cameron Brown, Farah Zarka, Aurélien Delluc, Marc Carrier","doi":"10.1016/j.tru.2024.100182","DOIUrl":"https://doi.org/10.1016/j.tru.2024.100182","url":null,"abstract":"<div><h3>Background</h3><p>Gonadal vein thrombosis (GVT) is an uncommon condition that has been associated with different risk factors (e.g., post-partum period, cancer, recent pelvic surgery, etc.). The optimal management of GVT remains unclear. We sought to assess the efficacy and safety of anticoagulation therapy in adult patients with GVT.</p></div><div><h3>Methods</h3><p>A systematic search of MEDLINE, EMBASE and PubMed, from inception to February 2023 was performed. The primary efficacy outcome was recurrent venous thromboembolism (VTE). Bleeding outcomes were assessed in the form of major and clinically relevant non-major bleeding (CRNMB) events. Incidence rates of the outcomes were pooled using the random effects model and expressed as event per 100 patient-years with its associated 95 % confidence intervals (CI) using R software.</p></div><div><h3>Results</h3><p>A total of 14 observational studies and one randomized controlled trial (1134 patients) with GVT met the inclusion criteria and were included in the review. Overall, 429 (37.8 %) patients were treated with anticoagulation. The rate of recurrent VTE was 3.1 per 100 patient-years (95 % CI, 1.6–6.3). The rate of major bleeding and CRNMB events were 1.0 (95 % CI; 0.2–4.5) and 9.9 (95 % CI; 2.6–37.8) per 100 patient-years, respectively.</p></div><div><h3>Conclusion</h3><p>Gonadal vein thrombosis seems to be associated with a relatively low risk of recurrent VTE and bleeding complications. The risk benefit ratio of anticoagulant therapy remains unclear in this patient population.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572724000245/pdfft?md5=227ccae830e5007a63ab9e4964f2f095&pid=1-s2.0-S2666572724000245-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141593593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}