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. 2021 May 25:37:12.
doi: 10.5758/vsi.200075.

Association between Laterality and Location of Deep Vein Thrombosis of Lower Extremity and Pulmonary Embolism

Sangmin Gong  1 , Eun Ji Lee  1 , Jin Sung Kim  1 , Hyangkyoung Kim  2 , Minsu Noh  1 , Hojong Park  1 , Bong Won Park  1 , Songsoo Yang  1 , Sang Jun Park  1
Affiliations

Association between Laterality and Location of Deep Vein Thrombosis of Lower Extremity and Pulmonary Embolism

Sangmin Gong et al. Vasc Specialist Int. .

Abstract

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.

Keywords: Computed tomography angiography; Mortality; Pulmonary embolism; Venous thrombosis.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Classification of pulmonary embolism (PE). PE was classified based on the location of the emboli observed on the computed tomography scan. (A) Main, (B) lobar, (C) segmental and (D) subsegmental PE. Black and white arrows indicate PEs.
Fig. 2
Fig. 2
Mosaic plot of pulmonary embolism, laterality, and proximal extent of deep vein thrombosis (DVT). Embolism of the main pulmonary artery developed more frequently in patients with DVT of the right femoral vein.
See this image and copyright information in PMC

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