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    Oral Communication

    Venous Thromboembolism

    Post-Thrombotic Syndrome

    OC 34.5 - Very long-term risk of Post-Thrombotic Syndrome after Deep Vein Thrombosis: The OPTIMEV study

    Monday, June 26, 2023
    11:45 – 12:00 ET
    Room: 520
    Session Available As: On-Demand
    Background: Two years after a lower extremity proximal deep-vein thrombosis (DVT), up to 50% of patients develop post thrombotic syndrome (PTS) and 5-10% develop moderate-severe PTS, which can severely impact their quality of life. Risk of moderate-severe PTS has been poorly studied in the very long-term. The impact of DVT vs. non-DVT-related chronic venous insufficiency (CVI) on long-term PTS manifestations is unknown.

    Aims: To assess very long-term risk of moderate-severe PTS and impact of DVT on this risk.

    Methods: Patients with proximal and distal DVT and a random selection of patients without history of DVT or pulmonary embolism (‘controls’) enrolled in the observational, multicenter OPTIMEV study underwent a long-term (14 years) phone follow-up visit. We assessed i) proportion of moderate-severe PTS/CVI (patient-reported Villalta score (PRVS)≥10 or presence of a venous ulcer in the leg ipsilateral to DVT for DVT patients or in any legs for controls) in each group and, ii) the attributable risk (AR) and the fraction of attributable risk (FAR) to DVT in moderate-severe PTS/CVI manifestations.

    Results: Patients’ baseline characteristics and proportion of moderate-severe PTS/CVI in each group are presented in Tables 1 & 2. Among patients with a single episode of proximal DVT (n=92), 26.1% developed moderate-severe PTS/CVI. AR and FAR of DVT in moderate-severe PTS/CVI manifestations were 5.4% and 26.1% respectively; Respective AR and FAR of DVT in patients with proximal DVT and previous or recurrent DVT (n=19, 48.3% have moderate-severe PTS/CVI) were 27.6% and 57.1%; AR and FAR were not assessable in patients with distal DVT (no increased risk).

    Conclusion(s): In the very long-term, after proximal DVT, almost a third of patients have moderate-severe PTS/CVI. However, the true impact of a first proximal DVT on these manifestations of PTS/CVI appear limited. Distal DVT does not increase the risk of developing moderate-severe PTS/CVI in the very long-term.

    Learning Objectives:

    • Upon completion, participant will be able to know what is the overall risk of burdensome post thrombotic syndrome after a DVT in the very long term
    • Upon completion, participant will be able to understand the true impact of DVT on patients' symptoms of chronic venous insufficiency
    • Upon completion, participant will be able to know what is the risk of burdensome post thrombotic syndrome after an isolated distal DVT in the very long term