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Ovarian Vein Thrombosis: a retrospective cohort study

1University of Insubria, Como, Lombardia, Italy, 2School of Medicine, University of Insubria, Varese, Varese, Lombardia, Italy, 3Department of Medicine and Surgery, Research Center on Thromboembolic Disorders and Antithrombotic Therapies, University of Insubria, Varese, Italy., VARESE, Lombardia, Italy, 4Research Center on Thromboembolic Disorders and Antithrombotic Therapies, University of Insubria, Varese, VARESE, Lombardia, Italy

Abstract Number: PB0433

Meeting: ISTH 2022 Congress

Theme: Venous Thromboembolism » Visceral Vein Thrombosis

Background: Ovarian vein thrombosis (OVT) is an unusual manifestation of venous thromboembolism (VTE), with a lack of evidence on its management.

Aims: To collect data about OVT characteristics, anticoagulant therapy (AC) and outcomes.

Methods: Observational, monocentric, retrospective study including consecutive adult patients diagnosed with OVT from 2007 to 2021 and referred to the Thrombosis center of Varese hospital. Data were collected on demographics characteristics, clinical presentation, OVT extension, AC, VTE recurrence and bleeding events.

Results: 38 women were included, with a mean age of 57.6 ± 19.8 years. 32 patients (84%) had at least one major VTE risk factor: cancer 23 (60.5%), chemotherapy 13 (34,2%), surgery or major trauma in the last 3 months 8 (21%), infection 2 (5.2%), pregnancy/post-partum 3 (8%), hormonal therapy 3 (7.9%), previous VTE 2 (5%). Most of the patients (31/38) were asymptomatic.

Left ovarian vein was involved in 32 patients (84%). Pulmonary embolism (PE) was diagnosed in 2 (5%) cases.

30 patients (78.9%) received AC with low molecular weight heparin (LMWH) as initial treatment, mainly at full dose (28/30); 2 (6,6%) received lower doses due to brain metastasis or acute renal insufficiency. 20 patients (66,6%) received extended anticoagulation (>3 months), either with LMWH (16; 8%) or warfarin (3; 15%) or apixaban (1; 5%). 2 patients were subsequently switched from LMWH to apixaban.

Over a mean follow up of 32.7 months, recurrent VTE occurred in 1 patient (2.6%) who had been previously treated with AC; there were 8 bleeding events (21%), including 3 major (7.9%).

Conclusion(s): OVT was often incidentally diagnosed, and it was rarely associated with concomitant PE. Cancer and surgery were frequent risk factors. Most of the patients received AT. During follow-up major bleedings were not negligible, whereas recurrent VTE was low.

To cite this abstract in AMA style:

De Pascali F, Foti N, Ageno W, Donadini M. Ovarian Vein Thrombosis: a retrospective cohort study [abstract]. https://abstracts.isth.org/abstract/ovarian-vein-thrombosis-a-retrospective-cohort-study/. Accessed September 29, 2023.

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