Aktuelles zu Inzidenz, Risikofaktoren und Behandlung von venösen Thrombosen an ungewöhnlichen Stellen

Laura Girardi; Lucia Maria Caiano; Matteo Guarascio; Walter Ageno

doi:10.1055/a-2220-5879

Phlebologie, Table of Contents

Phlebologie 2024; 53(02): 78-87
DOI: 10.1055/a-2220-5879

Curriculare Fortbildung

Updates in the Incidence, Risk Factors, and Management of Venous Thrombosis in Unusual Sites

Splanchnic, Cerebral, and Retinal Vein Involvements Article in several languages: deutsch | English

Authors

Laura Girardi
Lucia Maria Caiano
Matteo Guarascio
Walter Ageno

Abstract

The term unusual site venous thrombosis refers to uncommon manifestations of venous thromboembolism (VTE) that occur outside of the lower limbs and the pulmonary arteries. The management of unusual site VTE is challenging due to the heterogeneity of clinical presentations and predisposing factors, and to the lack of high-quality evidence to drive treatment strategies. The purpose of this narrative review is to summarize the available evidence and to provide practical guidance on the management of unusual site VTE.

Keywords

venous thromboembolism - splanchnic vein thrombosis - cerebral vein thrombosis - retinal vein occlusion - hemorrhage - anticoagulation treatments

Full Text

References

Literatur
1 Thatipelli MR, McBane RD, Hodge DO. et al. “Survival and recurrence in patients with splanchnic vein thromboses”. Clin Gastroenterol Hepatol 2010; 8 (02) 200-205
2 Riva N. et al. “Clinical history and antithrombotic treatment of incidentally detected splanchnic vein thrombosis: a multicentre, international prospective registry”. Lancet Haematol 2016; 3 (06) e267-e275
3 Bach AM. et al. “Portal vein evaluation with US: comparison to angiography combined with CT arterial portography”. Radiology 1996; 201 (01) 149-154
4 Rajesh S, Mukund A, Arora A. “Imaging Diagnosis of Splanchnic Venous Thrombosis”. Gastroenterol Res Pract 2015; 2015
5 de Stefano V, Martinelli I. “Splanchnic vein thrombosis: clinical presentation, risk factors and treatment”. Intern Emerg Med 2010; 5 (06) 487-494
6 Ageno W. et al. “Long-term Clinical Outcomes of Splanchnic Vein Thrombosis: Results of an International Registry”. JAMA Intern Med 2015; 175 (09) 1474-1480
7 Condat B. et al. “Current outcome of portal vein thrombosis in adults: Risk and benefit of anticoagulant therapy”. Gastroenterology 2001; 120 (02) 490-497
8 Spaander MCW, Hoekstra J, Hansen BE. et al. “Anticoagulant therapy in patients with non-cirrhotic portal vein thrombosis: effect on new thrombotic events and gastrointestinal bleeding”. J Thromb Haemost 2013; 11 (03) 452-459
9 Candeloro M. et al. “Anticoagulant therapy for splanchnic vein thrombosis: an individual patient data meta-analysis”. Blood Adv 2022; 6 (15) 4516-4523
10 Ageno W, Beyer-Westendorf J, Garcia DA. et al. “Guidance for the management of venous thrombosis in unusual sites”. J Thromb Thrombolysis 2016; 41 (01) 129-143
11 Ageno W. “Treatment of Atypical Clots”. Hamostaseologie 2022; 42 (01) 10-18
12 Di Nisio M, Valeriani E, Riva N. et al. “Anticoagulant therapy for splanchnic vein thrombosis: ISTH SSC Subcommittee Control of Anticoagulation”. J Thromb Haemost 2020; 18 (07) 1562-1568
13 “S2k-Leitlinie Federführende Fachgesellschaft: Deutsche Gesellschaft für Angiologie-Gesellschaft für Gefäßmedizin”. 2023
14 Naymagon L. et al. “The efficacy and safety of direct oral anticoagulants in noncirrhotic portal vein thrombosis”. Blood Adv 2020; 4 (04) 655-666
15 Ageno W. et al. “Rivaroxaban for the treatment of noncirrhotic splanchnic vein thrombosis: an interventional prospective cohort study”. Blood Adv 2022; 6 (12) 3569-3578
16 Elie Plessier A. et al. “Rivaroxaban Prophylaxis in Noncirrhotic Portal Vein Thrombosis”. NEJM Evidence 2022; 1 (12)
17 Mohan BP, Aravamudan VM, Khan SR. et al. “Treatment response and bleeding events associated with anticoagulant therapy of portal vein thrombosis in cirrhotic patients: Systematic review and meta-analysis”. Ann Gastroenterol 2020; 33 (05) 521-527
18 Smalberg JH. et al. “Risks and benefits of transcatheter thrombolytic therapy in patients with splanchnic venous thrombosis”. Thromb Haemost 2008; 100 (06) 1084-1088
19 Riva N, Ageno W. “Approach to thrombosis at unusual sites: Splanchnic and cerebral vein thrombosis”. Vasc Med 2017; 22 (06) 529-540
20 Ropper AH, Klein JP. “Cerebral Venous Thrombosis”. N Engl J Med 2021; 385 (01) 59-64
21 Dentali F. et al. “Long-term outcomes of patients with cerebral vein thrombosis: a multicenter study”. J Thromb Haemost 2012; 10 (07) 1297-1302
22 Ferro JM, Canhão P, Stam J. et al. “Prognosis of Cerebral Vein and Dural Sinus Thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)”. Stroke 2004; 35 (03) 664-670
23 Dentali F. et al. “Long-term outcomes of patients with cerebral vein thrombosis: A multicenter study”. Journal of Thrombosis and Haemostasis 2012; 10 (07) 1297-1302
24 Dentali F, Crowther M, Ageno W. “Thrombophilic abnormalities, oral contraceptives, and risk of cerebral vein thrombosis: a meta-analysis”. Blood 2006; 107 (07) 2766-2773
25 Martinelli I. “Cerebral vein thrombosis”. Thromb Res 2013; 131 (Suppl. 01)
26 Leal Rato M, Bandeira M, Romão VC. et al “Neurologic Manifestations of the Antiphospholipid Syndrome – an Update”. Current Neurology and Neuroscience Reports 2021; Springer 21 (08)
27 Ferro JM. et al. “European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – endorsed by the European Academy of Neurology”. Eur J Neurol 2017; 24 (10) 1203-1213
28 Gangat N. et al. “Cerebral venous thrombosis and myeloproliferative neoplasms: A three-center study of 74 consecutive cases”. Am J Hematol 2021; 96 (12) 1580-1586
29 Ferro JM. et al. “European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – endorsed by the European Academy of Neurology”. Eur J Neurol 2017; 24 (10) 1203-1213
30 Ferro JM. et al. “Safety and Efficacy of Dabigatran Etexilate vs Dose-Adjusted Warfarin in Patients With Cerebral Venous Thrombosis: A Randomized Clinical Trial”. JAMA Neurol 2019; 76 (12) 1457-1465
31 Connor P. et al. “Safety and efficacy of rivaroxaban in pediatric cerebral venous thrombosis (EINSTEIN-Jr CVT)”. Blood Adv 2020; 4 (24) 6250-6258
32 Yaghi S. et al. “Direct Oral Anticoagulants Versus Warfarin in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT): A Multicenter International Study”. Stroke 2022; 53 (03) 728-738
33 Field TS. et al. “Study of Rivaroxaban for Cerebral Venous Thrombosis: A Randomized Controlled Feasibility Trial Comparing Anticoagulation With Rivaroxaban to Standard-of-Care in Symptomatic Cerebral Venous Thrombosis”. Stroke 2023; 54 (11)
34 Nepal G. et al “Safety and efficacy of Direct Oral Anticoagulants in cerebral venous thrombosis: A meta-analysis”. Acta Neurologica Scandinavica 2022; John Wiley and Sons Inc 145 (01) 10-23
35 Riat R, Gomez K. “Addendum to guidelines on the investigation and management of venous thrombosis at unusual sites (Br. J. Haematol. 2012;159:28-38): Use of Direct Oral Anticoagulants”. Br J Haematol 2022; 198 (01) 46-49
36 Song P, Xu Y, Zha M. et al. “Global epidemiology of retinal vein occlusion: a systematic review and meta-analysis of prevalence, incidence, and risk factors”. J Glob Health 2019; 9 (01)
37 Paciullo F, Giannandrea D, Virgili G. et al. “Role of Increased Lipoprotein (a) in Retinal Vein Occlusion: A Systematic Review and Meta-analysis”. TH Open 2021; 5 (03) e295-e302
38 Russell MW. et al. “Lack of association between Lp(a) and retinal vein occlusion in a single institution and US national database”. Can J Ophthalmol 2023;
39 Hernández JL. et al. “Antiphospholipid syndrome and antiphospholipid antibody profile in patients with retinal vein occlusion”. Thromb Res 2020; 190: 63-68
40 Romiti GF. et al. “Inherited and acquired thrombophilia in adults with retinal vascular occlusion: A systematic review and meta-analysis”. J Thromb Haemost 2020; 18 (12) 3249-3266
41 Paciullo F. et al. “Antithrombotic treatment of retinal vein occlusion: a position statement from the Italian Society on Thrombosis and Haemostasis (SISET)”. Blood Transfus 2022; 20 (04) 341-347
42 Lazo-Langner A, Hawel J, Ageno W. et al. “Low molecular weight heparin for the treatment of retinal vein occlusion: a systematic review and meta-analysis of randomized trials”. Haematologica 2010; 95 (09) 1587-1593
43 Valeriani E. et al. “Antithrombotic treatment for retinal vein occlusion: a systematic review and meta-analysis”. J Thromb Haemost 2023; 21 (02) 284-293
44 Cugati S. et al. “Retinal vein occlusion and vascular mortality: pooled data analysis of 2 population-based cohorts”. Ophthalmology 2007; 114 (03) 520-524
45 Khan Z, Almeida DRP, Rahim K. et al. “10-Year Framingham risk in patients with retinal vein occlusion: a systematic review and meta-analysis”. Can J Ophthalmol 2013; 48 (01)