Abstract Number: PB0434
Meeting: ISTH 2022 Congress
Background: Ovarian vein thrombosis (OVT) is a rare category of venous thromboembolism (VTE). It is usually reported during pregnancy/puerperium, but risk factors also include malignancies, pelvic surgery and local infections. The treatment typically consists of antibiotics and anticoagulants; however, it is debated whether anticoagulation is appropriate for all aetiologies of OVT.
Aims: To evaluate safety and efficacy of anticoagulant treatment for OVT by performing a systematic review of the literature and meta-analysis.
Methods: The protocol was registered a priori in PROSPERO (CRD42021270883). We performed a bibliographic search within the electronic databases MEDLINE, EMBASE and CENTRAL from inception to July 2021. We included randomized control trials and observational studies/case-series enrolling at least 10 adult patients diagnosed with OVT and treated with any anticoagulant drugs. The following outcomes were extracted: mortality, major bleeding and recurrent VTE during anticoagulant treatment, and vessel recanalization. We calculated weighted mean proportions using a random-effects model.
Results: We retrieved 11 observational studies enrolling OVT patients treated with anticoagulants (n=361); 4 studies evaluated also OVT patients who were not anticoagulated (n=286). Six studies included only post-partum OVT, while the remaining included mixed aetiologies.
The most common anticoagulants were warfarin and heparin; average treatment duration ranged from 1 to 9 months. In treated patients, mortality rate was 2.18% (95% CI, 0-10.03%; I2=63.0%; 4/134 patients, 5 studies); major bleeding 0.95% (95% CI, 0-3.60%; I2=0%; 1/129 patients, 2 studies); recurrent VTE 2.10% (95% CI, 0.04-6.16%; I2=4.2%; 2/101, 5 studies); and vessel recanalization 92.8% (95% CI, 74.6-100%; I2=83.2%; 134/149 patients, 6 studies). The rate of recurrent VTE in untreated patients was 9.88% (95% CI, 5.95-14.65%; I2=0%; 18/184 patients, 2 studies).
Conclusion(s): There is a scarcity of literature available on the use of anticoagulation for OVT. Our results suggest that anticoagulant treatment is associated with reduced VTE recurrence and low major bleeding events.
To cite this abstract in AMA style:
Vassallo C, Muscat Baron L, Riva N, Gatt A, Calleja-Agius J. Safety and efficacy of anticoagulant treatment in patients with ovarian vein thrombosis: A systematic review and meta-analysis [abstract]. https://abstracts.isth.org/abstract/safety-and-efficacy-of-anticoagulant-treatment-in-patients-with-ovarian-vein-thrombosis-a-systematic-review-and-meta-analysis/. Accessed September 29, 2023.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/safety-and-efficacy-of-anticoagulant-treatment-in-patients-with-ovarian-vein-thrombosis-a-systematic-review-and-meta-analysis/