OC 34.3 - Walking capacity in patients with acute deep vein thrombosis is associated with the location of thrombosis and is reduced in patients with a history of previous deep vein thrombosis

Monday, June 26, 2023

11:15 – 11:30 ET

Room: 520

Session Available As: On-Demand

Presenting Author(s)

Daniel Steiner, MD

PhD Student
Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria

Co-Author(s)

Stephan Nopp, MD

PhD Student
Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria
Ingrid Pabinger, MD

Co-Head of the Thrombosis and Haemostasis Research Group
Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria
ED

Eva Dassler

Technician
Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria
BW

Benedikt Weber

Professor
Department of Dermatology, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria
RK

Renate Koppensteiner

Head of Department
Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria
Cihan Ay, MD (he/him/his)

Professor, Head of the Thrombosis and Haemostasis Research Group
Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria
OS

Oliver Schlager

Professor
Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria

Background: Patients suffering from deep vein thrombosis (DVT) are at risk for short- and long-term consequences, including venous claudication in post-thrombotic syndrome. The effect of DVT on walking capacity during the acute phase has not been studied.

Aims: In this study, we aimed to evaluate walking capacity in patients with acute DVT on a treadmill ergometer and assess its association with DVT location and history of previous DVT.

Methods: Treadmill speed was set to 3.2 km/h using a 12 degree slope. Pain-free walking distance (PWD), maximum walking distance (MWD), and symptoms during testing, including reasons for early termination, were recorded. In the absence of symptoms, the test was terminated at a maximum of 750 meters.

Results: We included 58 patients with a median (IQR) age of 54.1 (44.5-59.9) years; 31% were female (Table 1). None of the patients had peripheral artery disease or any other comorbidity causing walking impairment. Median (IQR) time from diagnosis to treadmill exercise test was 3 (1-5) days. Median (IQR) PWD and MWD were 35 (0-150) and 385 (110-750) meters, respectively. Twenty-nine percent of patients had to stop due to venous claudication. PWD and MWD stratified by DVT location are shown in Fig. 1. Patients with iliocaval DVT had worse outcomes compared to patients with femoropopliteal/infrapopliteal DVT (PWD 20 (0-30) versus 50 (0-213) meters, p=0.086; MWD 130 (61-203) versus 600 (143-750) meters, p=0.003). Furthermore, a larger proportion of patients with iliocaval DVT had to terminate treadmill test due to claudication (58.3% versus 21.7%). Patients with history of previous DVT (n=15, 25.9%) also tended to have more severe impairment (PWD 20 (0-160) meters, MWD 270 (115-750) meters, termination due to claudication 40.0%).

Conclusion(s): In our study, patients with acute DVT had considerable functional limitations in their walking capacity. Iliocaval location and history of previous DVT aggravated these limitations.

Learning Objectives:

Upon completion, participants will be able to describe the process of a standardized treadmill exercise test.
Upon completion, participants will be able to discuss the location of thrombosis and a history of previous deep vein thrombosis as potential modifiers of walking capacity in patients with acute deep vein thrombosis.
Upon completion, participants will be able to recognize the impact of walking impairment in patients with acute deep vein thrombosis on self-reported quality of life.