CC BY-NC-ND 4.0 · Semin Thromb Hemost
DOI: 10.1055/s-0041-1729169
Review Article

Profile of Patients with Isolated Distal Deep Vein Thrombosis versus Proximal Deep Vein Thrombosis or Pulmonary Embolism: RE-COVERY DVT/PE Study

Sebastian Schellong
1  Medical Department 2, Municipal Hospital Dresden, Dresden, Germany
Walter Ageno
2  Department of Medicine and Surgery, University of Insubria, Varese, Italy
Ivan B. Casella
3  Department of Surgery, Clinics Hospital, University of São Paulo, São Paulo, Brazil
Kok Han Chee
4  Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Sam Schulman
5  Department of Medicine, Thrombosis and Atherosclerosis Research Institute and McMaster University, Hamilton, Ontario, Canada
6  Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
Daniel E. Singer
7  Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
Marc Desch
8  CardioMetabolism Respiratory Medicine, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
Wenbo Tang
9  Biostatistics and Data Sciences, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut
Isabelle Voccia
10  Clinical Operations, Boehringer Ingelheim Canada, Burlington, Ontario, Canada
Kristina Zint
11  Department of Epidemiology, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
Samuel Z. Goldhaber
12  Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
› Author Affiliations


Isolated distal deep vein thrombosis (IDDVT) is presumed to be more benign than proximal DVT (PDVT) or pulmonary embolism (PE), suggesting a need for different management approaches. This subgroup analysis of the RE-COVERY DVT/PE global, observational study investigated patient characteristics, hospitalization details, and anticoagulant therapy in patients with IDDVT in real-world settings in 34 countries enrolled from January 2016 to May 2017. Data were analyzed descriptively according to the type and location of the index venous thromboembolism (VTE): IDDVT, PDVT ± distal DVT (DDVT), and PE ± DVT. Of the 6,095 eligible patients, 323 with DVT located outside the lower limb and no PE were excluded. Of the remaining 5,772 patients, 17.6% had IDDVT, 39.9% had PDVT ± DDVT, and 42.5% had PE ± DVT. IDDVT patients were younger and had fewer risk factors for VTE than the other groups. Other comorbidities were less frequent in the IDDVT group, except for varicose veins, superficial thrombophlebitis, and venous insufficiency. IDDVT patients were less likely to be diagnosed in an emergency department (22.3 vs. 29.7% for PDVT ± DDVT and 45.4% for PE ± DVT) or hospitalized for VTE (29.2 vs. 48.5% for PDVT ± DDVT and 75.0% for PE ± DVT). At hospital discharge or 14 days after diagnosis (whichever was later), non–vitamin K antagonist oral anticoagulants were the most commonly used anticoagulants (55.6% for IDDVT, 54.7% for PDVT ± DDVT, and 52.8% for PE ± DVT). Although differences in patient characteristics, risk factors, and clinical management were identified, anticoagulant treatment of IDDVT was almost equal to that of PDVT or PE. Prospective studies should investigate whether, in a global perspective, this is an appropriate use of anticoagulants.

Trial registration number NCT02596230.

Authors' Contributions

S.S. was responsible for the concept of the secondary analyses presented in this manuscript. W.T. was responsible for the data analysis. All authors were responsible for the study concept and design; interpretation of the data; preparation, review, or approval of the manuscript; revision of intellectual content; and the decision to submit the manuscript for publication.

Publication History

Publication Date:
10 May 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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