PB0433 - Ovarian Vein Thrombosis: a retrospective cohort study

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Federica De Pascali, MD

Internal Medicine Resident
University of Insubria
Como, Lombardia, Italy

Co-Author(s)

NF

Nicolò Foti

MD
School of Medicine, University of Insubria, Varese
Varese, Lombardia, Italy
Walter Ageno, MD

Professor of Medicine
Department of Medicine and Surgery, University of Insubria, Varese, Italy
Varese, Lombardia, Italy
MD

Marco Paolo Donadini, MD, PhD

Professor of Internal Medicine
Department of Medicine and Surgery, University of Insubria, Varese, Italy
Varese, Lombardia, Italy

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.