Ovarian Vein Thrombosis: Incidence of Recurrent Venous Thromboembolism and Survival

Charles J. Lenz, Waldemar E. Wysokinski, Stanislav Henkin, Kevin P. Cohoon, Ana Casanegra, Benjamin S. Simmons, Rayya A. Saadiq, Paul R. Daniels, Ewa M. Wysokinska, Haraldur Bjarnason, Robert D. McBane

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To identify the risk of venous thromboembolism recurrence, major bleeding, and mortality in patients with ovarian vein thrombosis so as to better define optimal treatment strategies.

METHODS: Patients with ovarian vein thrombosis (1990-2015) and age- and gender-matched patients with contemporary leg deep vein thrombosis (DVT) were assessed for differences in etiology, venous thromboembolism recurrence, and survival in a case-control study.

RESULTS: Over the timeframe of this study, only 219 ovarian vein thrombosis cases were identified compared with 13,417 leg DVTs. Median duration of follow-up was 1.23 years (interquartile range 0.25-4.14). Pulmonary embolism was identified at presentation in 6% of patients with ovarian vein thrombosis and 16% of those with DVT (P=.001). Frequent causes of ovarian vein thrombosis included cancer, hormonal stimulation, surgery, and hospitalization. Cancer was twofold more frequent in patients with ovarian vein thrombosis (44% compared with 21%; P<.01). Despite being less frequently treated with anticoagulation (ovarian vein thrombosis 54% compared with DVT 98%, P<.001), venous thromboembolism recurrence rates were similar between groups (ovarian vein thrombosis 2.3 compared with DVT 1.8 per 100 patient-years, P=.49). A personal history of venous thromboembolism and preceding surgery was found to be an independent risk factor for venous thromboembolism recurrence among those treated with anticoagulation (hazard ratio 6.7, P=.04 and hazard ratio 13.6, P=.03, respectively). There was no significant difference in overall survival.

CONCLUSION: Ovarian vein thrombosis is a rare thrombotic condition with an incidence 60-fold lower compared with leg DVT in our institution. The striking association with cancer adversely affects overall survival rates in patients with ovarian vein thrombosis. Venous thromboembolism recurrence rates argue for anticoagulation with a direct oral anticoagulant or vitamin K antagonist, particularly in those with a history of venous thromboembolism.

Original languageEnglish (US)
Pages (from-to)1127-1135
Number of pages9
JournalObstetrics and Gynecology
Volume130
Issue number5
DOIs
StatePublished - Nov 1 2017

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Venous Thromboembolism
Veins
Thrombosis
Survival
Incidence
Venous Thrombosis
Recurrence
Leg
Neoplasms
Vitamin K
Pulmonary Embolism
Anticoagulants
Case-Control Studies
Hospitalization
Survival Rate
Hemorrhage
Mortality

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Lenz, C. J., Wysokinski, W. E., Henkin, S., Cohoon, K. P., Casanegra, A., Simmons, B. S., ... McBane, R. D. (2017). Ovarian Vein Thrombosis: Incidence of Recurrent Venous Thromboembolism and Survival. Obstetrics and Gynecology, 130(5), 1127-1135. https://doi.org/10.1097/AOG.0000000000002319

Ovarian Vein Thrombosis : Incidence of Recurrent Venous Thromboembolism and Survival. / Lenz, Charles J.; Wysokinski, Waldemar E.; Henkin, Stanislav; Cohoon, Kevin P.; Casanegra, Ana; Simmons, Benjamin S.; Saadiq, Rayya A.; Daniels, Paul R.; Wysokinska, Ewa M.; Bjarnason, Haraldur; McBane, Robert D.

In: Obstetrics and Gynecology, Vol. 130, No. 5, 01.11.2017, p. 1127-1135.

Research output: Contribution to journalArticle

Lenz, CJ, Wysokinski, WE, Henkin, S, Cohoon, KP, Casanegra, A, Simmons, BS, Saadiq, RA, Daniels, PR, Wysokinska, EM, Bjarnason, H & McBane, RD 2017, 'Ovarian Vein Thrombosis: Incidence of Recurrent Venous Thromboembolism and Survival', Obstetrics and Gynecology, vol. 130, no. 5, pp. 1127-1135. https://doi.org/10.1097/AOG.0000000000002319
Lenz CJ, Wysokinski WE, Henkin S, Cohoon KP, Casanegra A, Simmons BS et al. Ovarian Vein Thrombosis: Incidence of Recurrent Venous Thromboembolism and Survival. Obstetrics and Gynecology. 2017 Nov 1;130(5):1127-1135. https://doi.org/10.1097/AOG.0000000000002319
Lenz, Charles J. ; Wysokinski, Waldemar E. ; Henkin, Stanislav ; Cohoon, Kevin P. ; Casanegra, Ana ; Simmons, Benjamin S. ; Saadiq, Rayya A. ; Daniels, Paul R. ; Wysokinska, Ewa M. ; Bjarnason, Haraldur ; McBane, Robert D. / Ovarian Vein Thrombosis : Incidence of Recurrent Venous Thromboembolism and Survival. In: Obstetrics and Gynecology. 2017 ; Vol. 130, No. 5. pp. 1127-1135.
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AU - Henkin, Stanislav

AU - Cohoon, Kevin P.

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AU - Simmons, Benjamin S.

AU - Saadiq, Rayya A.

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