Ovarian vein thrombosis: Incidence of recurrent venous thromboembolism and survival

SummaryFor patients with ovarian vein thrombosis (OVT), neither the rate of recurrence nor the expected survival are well established. Clarification of these natural history data would aid in defining the optimal management. We studied all female patients with OVT seen at the Mayo Clinic between 1990 and 2006. Survival, recurrent venous thrombosis rates, and prothrombotic factors were compared to a randomly selected group of 114 female patients with lower extremity venous thrombosis (DVT). Patients with OVT (n=35; mean age 44.8 ± 17.9 years) were significantly more likely to be under hormonal stimulation (48%), have an underlying malignancy (34%), experienced recent pelvic infection (23%) or undergone recent surgery (20%), compared to DVT patients. Duringa mean follow-up period of 34.6 ± 44.3 months, three patients suffered three recurrent venous thrombi (event rate: three per 100 patient years of follow-up).This recurrence rate was comparable to patients with lower extremity DVT (2.2 per 100 patient years). Recurrent thrombosis involved the contralateral ovarian vein, left renal vein, and inferior vena cava. The five-year mortality rate for OVT patients was 43% compared to 20% for DVT patients (p=0.08). All OVT deaths were cancer related. Survival was greater in OVT patients without cancer compared to those with active cancer (p<0.0001). In conclusion, venous thromboembolism recurrence rates are low and comparable to lower extremity DVT. Therefore general treatment guidelines for lower extremity DVT may be applicable. Poor survival rates in OVT are principally governed by the presence of malignancy.

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Postpartum ovarian vein thrombosis

Voprosy ginekologii akušerstva i perinatologii ◽

10.20953/1726-1678-2020-5-147-149 ◽

2020 ◽

Vol 19 (5) ◽

pp. 147-149

Author(s):

O.V. Papysheva ◽

◽

A.E. Voynovskiy ◽

A.I. Davydov ◽

M.B. Tairova ◽

...

Keyword(s):

Postpartum Period ◽

Clinical Case ◽

Inferior Vena ◽

Vena Cava ◽

Ovarian Vein ◽

Large Fragment ◽

Renal Veins ◽

Vein Thrombosis ◽

The Right ◽

Ovarian Vein Thrombosis

A clinical case of thrombosis of the right ovarian vein in the postpartum period - an extremely rare pathology in which acute appendicitis is often suspected due to the identity of the symptoms of the diseases. Performed laparoscopy, during which a large fragment of a thrombosed vein was excised. Conclusion. Extensive right ovarian vein thrombosis with a normal hemostasiogram could not only not be resolved by anticoagulants, but also potentially spread to the renal veins and inferior vena cava, increasing the risk of pulmonary embolism. Key words: vein dissection, laparoscopy, postpartum period, ovarian vein thrombosis

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Postpartum ovarian vein thrombosis and venous anatomical variation

BMJ Case Reports ◽

10.1136/bcr-2018-228399 ◽

2019 ◽

Vol 12 (6) ◽

pp. e228399

Author(s):

João Abrantes ◽

Eliana Teixeira ◽

Fernanda Gomes ◽

Clara Fernandes

Keyword(s):

Anatomical Variation ◽

Abdominal Ultrasound ◽

Ovarian Vein ◽

Vein Thrombosis ◽

Reactive Protein ◽

Abdominopelvic Ct ◽

Mild Leucocytosis ◽

And Control ◽

Ovarian Vein Thrombosis

A 34-year-old multipara presented 72 hours postpartum with acute right-sided abdominal pain. The investigation revealed mild leucocytosis with positive D-dimer and elevated C reactive protein. Abdominal ultrasound and abdominopelvic CT demonstrated an enlarged right ovarian vein with endoluminal thrombus, representing postpartum ovarian vein thrombosis. The patient became asymptomatic 48 hours after starting broad-spectrum antibiotic treatment and anticoagulant therapy. She completed the treatment in ambulatory regimen and control abdominopelvic CT imaging was performed and revealed a duplicated right ovarian vein and a small residual subacute thrombus in the lumen of the distal right ovarian vein. The patient remained asymptomatic in the clinical follow-up.

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Postpartum Ovarian Vein and Inferior Vena Cava Thrombosis

Case Reports in Medicine ◽

10.1155/2014/609187 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Harun Arslan ◽

Sibel Ada ◽

Sebahattin Çelik ◽

Tayfur Toptaş

Keyword(s):

Inferior Vena ◽

Rare Complication ◽

Vena Cava ◽

Ovarian Vein ◽

Pelvic Infection ◽

Vein Thrombosis ◽

Vena Cava Thrombosis ◽

Inferior Vena Cava Thrombosis ◽

Ovarian Abscess ◽

Ovarian Vein Thrombosis

Postpartum ovarian vein thrombosis (POVT), which generally occurs 2–15 days postpartum, is a rare complication. It can be confused with acute appendicitis, pelvic infection, ovarian torsion, tubo-ovarian abscess, and pyelonephritis. It is associated with morbidity and mortality. Here, we present a patient with postpartum OVT and IVC diagnosed by US and CT findings. She was treated successfully with no further need for any interventional procedures.

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Postpartum inferior vena cava and ovarian vein thrombosis – A case report and literature review

Journal of Obstetrics and Gynaecology ◽

10.1080/01443610500106835 ◽

2005 ◽

Vol 25 (3) ◽

pp. 312-313 ◽

Cited By ~ 16

Author(s):

D Sinha ◽

H Yasmin ◽

JS Samra

Keyword(s):

Case Report ◽

Literature Review ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Ovarian Vein ◽

Vein Thrombosis ◽

Ovarian Vein Thrombosis

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Ovarian Vein Thrombosis Extending to Inferior Vena Cava in Postpartum Period: Case Reports and Literature Review

Flebologiia ◽

10.17116/flebo202014031244 ◽

2020 ◽

Vol 14 (3) ◽

pp. 244

Author(s):

I.S. Lebedev ◽

D.A. Son ◽

D.A. Churikov ◽

O.I. Efremova ◽

S.M. Yumin ◽

...

Keyword(s):

Literature Review ◽

Inferior Vena Cava ◽

Postpartum Period ◽

Inferior Vena ◽

Case Reports ◽

Vena Cava ◽

Ovarian Vein ◽

Vein Thrombosis ◽

Ovarian Vein Thrombosis

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Biliary tract cancers and the associated risk of venous thromboembolism.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.304 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 304-304

Author(s):

Jasleen Khanuja ◽

Samira Bahrami Tabar ◽

Denice Tsao-Wei ◽

Caroline Irene Piatek ◽

Afsaneh Barzi

Keyword(s):

Venous Thromboembolism ◽

Los Angeles ◽

Biliary Tract ◽

Medical Center ◽

Vena Cava ◽

Cancer Center ◽

Logrank Test ◽

Biliary Tract Cancers ◽

Vein Thrombosis

304 Background: Venous thromboembolism (VTE) is a common cause of morbidity and mortality in cancer patients. Because biliary tract cancers (BTC) cholangiocarcinoma and gallbladder (GB) cancer are uncommon, the incidence of VTE in this population are not well-described. Methods: We conducted a retrospective study of patients with BTC identified by the cancer registry at the Los Angeles County-University of Southern California (USC) Medical Center, USC Norris Cancer Center, and USC Keck Hospital between January 2011 to December 2016 to describe the incidence of VTE. 330 BTC patients’ medical records were reviewed for demographics, tumor characteristics, treatment history, and VTE events. 41 patients were excluded due to incomplete records/follow-up. Overall survival (OS) was calculated from date of diagnosis to date of death or last follow-up. Logrank test was used to evaluate the association of VTE with OS. Results: 289 patients with BTC were identified (177 cholangiocarcinoma, 112 GB) with a median follow-up period of 16.7 (0.3-89.0) months (mo). 169 (58%) were women. The median age at diagnosis of 66 years (range 22-89). 144 (59%) underwent cancer surgery and 274 (95%) received chemotherapy. 65 (22%) patients had VTE events: 22 pulmonary embolism [PE] with or without lower extremity (LE) deep vein thrombosis [DVT], 15 with LE DVT alone, three with upper extremity DVT, and 30 with visceral thrombosis (27 portal vein thrombosis [PVT] with or without inferior vena cava thrombosis [IVC], 2 IVC thrombosis, two hepatic vein thrombosis). Five patients had both DVT/PE and visceral thrombosis. The median time from cancer diagnosis to VTE event was not met. Patients with a PVT or any visceral thrombosis had an inferior OS compared to those without (PVT: median OS 16.2 mo [95% CI 12.2-25.8] versus 7.5 [3.4-14.2], p = 0.10, visceral thrombosis: 17.0 mo [95% CI 11.8-25.9] versus 8.4 [95% CI 3.7-14.3], p = 0.30). There was a non-significant trend towards inferior OS in patients with any VTE event type (median OS 17.0 mo [95% CI 11.8-39.0] versus 11.4 [95% CI 7.2-18.4], p = 0.10). There was no difference in OS for patients with PE/DVT compared to those without. Conclusions: VTE is commonly observed in patients with BTC. Visceral thrombosis is associated with inferior survival in patients with BTC.

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Idiopathic bilateral ovarian vein thrombosis

BMJ Case Reports ◽

10.1136/bcr-2020-238243 ◽

2021 ◽

Vol 14 (2) ◽

pp. e238243

Author(s):

Joshua Christy ◽

Divya Jarugula ◽

Kavitha Kesari ◽

Arvind Kunadi

Keyword(s):

African American Woman ◽

Oral Anticoagulants ◽

Vena Cava ◽

American Woman ◽

Pelvic Surgery ◽

Ovarian Vein ◽

Vein Thrombosis ◽

History Of ◽

Inflammatory Bowel ◽

Ovarian Vein Thrombosis

Ovarian vein thrombosis (OVT) is a condition most commonly associated with malignancy, hypercoagulable disorders, pelvic surgery, trauma, inflammatory bowel disease and the postpartum period. Idiopathic bilateral OVT is extremely rare. We report the case of a 30-year-old African-American woman who presented with bilateral lower pelvic pain and nausea. She had no recent pelvic infections nor a personal or family history of malignancy or thrombophilia. Workup results for a hypercoagulable state was negative. A CT scan of the abdomen and pelvis revealed bilateral OVT. Treatment included novel oral anticoagulants or warfarin, with comparison studies showing a similar risk–benefit ratio. Repeat imaging is recommended after 40–60 days to determine the necessity for further anticoagulation. Emphasis is placed on starting anticoagulation early in order to reduce the risk of extension of the thrombus into the inferior vena cava, conversion to pulmonary embolism or increase in the risk of infection.

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Nonpuerperal Ovarian Vein Thrombosis: A Report of Seven Cases.

Blood ◽

10.1182/blood.v104.11.4038.4038 ◽

2004 ◽

Vol 104 (11) ◽

pp. 4038-4038

Author(s):

Debra Ferman ◽

Thomas P. Bradley ◽

Robin Warshawsky ◽

Steven L. Allen

Keyword(s):

Abdominal Pain ◽

Family History ◽

Vena Cava ◽

Lower Abdominal Pain ◽

Clinical Entity ◽

Ovarian Vein ◽

Symptomatic Disease ◽

Vein Thrombosis ◽

History Of ◽

Ovarian Vein Thrombosis

Abstract Background: Nonpuerperal ovarian vein thrombosis (OVT) is a rare clinical entity. Therapy is not well defined. OVT is usually asymptomatic. Improved CT and MR imaging technology enables OVT to be diagnosed with greater frequency. Nonpuerperal OVT may be a distinct clinical entity. Methods: The medical records of women with nonpuerperal OVT were reviewed and their clinical course and treatment recorded. Cases were identified by scanning a CT computerized database over the past 3 years with the key words ovarian vein thrombosis. Results: 7 patients (pts) were identified. Age range was 38–61, median 51 years. 3 pts had OVT on the left and 4 on the right. OVT followed a procedure in 2 pts. 2 pts with breast cancer developed OVT, 1 during adjuvant tamoxifen and 1 receiving chemotherapy for metastatic disease. 1 pt had AML in CR. 3 pts presented with lower abdominal pain on the involved side and 1 pt had lower abdominal pain on the opposite side. The 3 pts with cancer were asymptomatic. 4 pts had uterine fibroids. 1 developed OVT in the setting of an acute diarrheal illness. 1 pt had prior DVT and 1 a family history of DVT. Only 1 pt had a hypercoagulable evaluation; negative. 2 pts had clot extending to the junction with the inferior vena cava (IVC) and both were anticoagulated with enoxaparin followed by warfarin. 1 pt was anticoagulated with enoxaparin alone. No embolic complications occurred. Conclusion: 4 pts with OVT were symptomatic and 3 were detected incidentally. 2 developed OVT following procedures, 3 had predisposing underlying conditions, and 2 had a personal or family history of thrombosis. Optimum therapy is not defined. Symptomatic disease alone is not an indication for anticoagulation. Anticoagulation may be indicated if clot extends to the IVC.

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