Effect of Laterality and Location of Deep Vein Thrombosis on Pulmonary Embolism Occurrence

Sangmin Gong1 , Jin Sung Kim1 , Hyangkyoung Kim2 , Minsu Noh1 , Hojong Park1 , Sang Jun Park1*, Bong Won Park1 , Jae Chol Hwang3 , Songsoo Yang2 and Hong Rae Cho1

1 Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea 2 Department of Surgery, Division of Vascular Surgery, Asan Medical Center, Seoul, Korea 3 Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea

^*Correspondance to: Sang Jun Park 

 PDF  Full Text DOI: 10.25107/2474-1647.2927

Abstract

Background: Pulmonary Embolism (PE) is a major cause of morbidity and mortality associated with Deep Vein Thrombosis (DVT). The aim of this study was to investigate the relationship between the anatomical location of thrombi in the lower extremities and the development of PE. Materials and Methods: We collected and analyzed the data of patients diagnosed with DVT of the lower extremities between 2006 and 2015 if their Computed Tomography (CT) data was available for the identification of PE. We evaluated the relationship between the laterality and proximity of thrombi location, and the location of PE. The frequency and rate of PE based on the matched DVT were analyzed. Results: CT images were available for 388/452 patients with DVT. After excluding 32 cases of bilateral involvement, 356 cases were included for analysis in this study. The ratio of left to right leg DVT was 232:124. PEs developed in 121 (52%) patients with left-sided DVT and in 78 (63%) patients with right-sided DVT (P=0.052). PEs that affected main pulmonary arteries developed in 36 (16%) patients with left leg DVT and 30 (24%) patients with right leg DVT (P=0.045). The most frequent site of PE development was the left iliac vein (59/199, 29.6%). According to the affected anatomical segment of the leg by DVT, patients with DVT in the right femoral vein (50/78, 64.1%; P=0.016) had the highest rates of PE occurrence. Moreover, the most frequent site of thrombi in cases with main pulmonary artery involvement was the right femoral vein (23, 32%) (P=0.000). Conclusion: The incidence of left-sided lower extremity DVT was approximately twice that of rightsided DVT. However, the PE develops more frequently in patients with right-sided DVT than in those with left-sided DVT. Therefore, it is recommended to pay more attention to the development of PE in cases with right-sided DVT of the lower extremity.

Keywords

Deep vein thrombosis; Pulmonary embolisms; Mortality, Angiogram

Cite the article

Gong S, Sung Kim J, Kim H, Noh M, Park H, Jun Park S, et al. Effect of Laterality and Location of Deep Vein Thrombosis on Pulmonary Embolism Occurrence. Clin Surg. 2020; 5: 2927..