Key result
Right-sided DVT linked to higher PE risk vs left-sided DVT, driven by main PA emboli.
Why the study?
The relationship between the anatomical location of thrombi in lower extremity DVT and the development of pulmonary embolism was unclear.
Does right-sided lower extremity DVT increase the risk of developing pulmonary embolism compared to left-sided DVT?
Observational (n=356)
No
Does right-sided lower extremity DVT increase the risk of developing pulmonary embolism compared to left-sided DVT?
Absolute Event Rate: 62.9% vs 52.2%
p-value: p=0.052
Right-sided lower extremity DVT is associated with a higher frequency of pulmonary embolism, particularly in the main pulmonary arteries, compared to left-sided DVT.
Right-sided DVT was associated with higher PE incidence; observational data leave open whether laterality should guide surveillance protocols.
PURPOSE: The aim of this study was to investigate the relationship between the anatomical location of thrombi in the lower extremities and the development of pulmonary embolism (PE). MATERIALS AND METHODS: We collected and analyzed the data of patients diagnosed with deep vein thrombosis (DVT) of the lower extremities between 2006 and 2015, and included those whose computed tomography (CT) data were available for PE identification. We evaluated the relationship between the laterality and the proximal/distal location of the thrombi in lower extremites and the location of PE. RESULTS: CT images were available for 388/452 patients with DVT. After excluding 32 cases with bilateral involvement, 356 cases were included for analysis in this study. The ratio of DVT in the left:right leg was 232:124. PEs developed in 121 (52.2%) patients with left-sided DVT and in 78 (62.9%) with right-sided DVT (P=0.052). PEs in the main pulmonary arteries developed in 36 (15.5%) patients with left leg DVT and in 30 (24.2%) with right leg DVT (P=0.045). The most frequent site of thrombosis associated with the development of PE was the left iliac vein (59/199, 29.6%). According to the anatomical segment of the leg affected by DVT, patients with DVT in the right femoral vein (50/71, 70.4%; P=0.016) had the highest rate of occurrence of PE. CONCLUSION: PE develops more frequently in patients with right-sided DVT than in those with left-sided DVT. Therefore, careful observation for the possible development of PE is recommended in cases with right-sided DVT of the lower extremity.
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Gong et al. (2021) conducted an observational in Deep vein thrombosis of the lower extremity (n=356). Right-sided deep vein thrombosis vs. Left-sided deep vein thrombosis was evaluated on Development of pulmonary embolism (p=0.052). Right-sided deep vein thrombosis was associated with a higher rate of pulmonary embolism compared to left-sided thrombosis (62.9% vs 52.2%, P=0.052), particularly in the main pulmonary artery (24.2% vs 15.5%, P=0.045).
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