الفهرس 
DEEP VENOUS THROMBOSISOnly 14 pages are availabe for public view
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Abstract
Over the last years, attempts have been made to more precisely estimate the risk
of recurrence after an unprovoked DVT to improve the identification of patients who
clearly benefit from extended anticoagulation. Palareti and colleagues were the first to
show an association between levels of D-dimer and the risk of recurrence. (134)
In confirmation of these data, it was found that patients with unprovoked DVT
and a D-dimer <250 ng/mL 3 weeks after discontinuation of anticoagulation have a risk
of recurrence as low as 3.7% after 2 years. (84) According to another Italian study, the
high risk of recurrence of patients with abnormal D-dimer after discontinuation of
anticoagulation can be substantially reduced by extending anticoagulation. (70)
The risk of recurrent DVT is low during anticoagulant treatment (135). Once
anticoagulation is stopped, the recurrence risk increases depending on the number and
strength of risk factors present in an individual patient. (123)
PROLONG study confirmed that an abnormal D-dimer measured 1-month after
oral anticoagulant withdrawal is associated with a significantly higher risk of recurrence
than normal D-diner in patients with proximal DVT of the lower limbs. (136)
Bruinstroop et al., (137) showed that elevated D-dimer level measured 1-month after
discontinuation of OAT identify patients with unprovoked DVT at a significantly higher
risk of recurrent DVT. (137)
This study aims to assess the usefulness of D-dimer level as a tool for prediction
of DVT treatment duration.
This study was performed on 100 pateints came to Menoufia university hospital
from December 2017 to December 2018.
All patients were selected according to inclusion and exclusion criteria. All
patients were evaluated by vascular team doctors in the hospitals. Evaluation included
history taking, physical examination, laboratory tests and radiological imaging.
All the 100 patients presented with high D-dimer level 1 month after stopping
oral anticoagulant (vitamin K) therapy, all did the same type of quantitative D-dimer
test, and ultrasound on the thrombosed limb.
After randomizing the patients into 2 groups, the first was planned to resume
anticoagulant for 3 months and the second was planned not to take any more
anticoagulant, all was followed up for duration from 8 till 12 months, during this period
patients came to outpatient clinic at least once per month, all was told to came to
emergency if any of the recurrent or complication symptoms appeared.
All the cases presented with recurrent DVT from both groups (8 cases) was reexamined
to identify any provoking factor lead to recurrent, and was advised to
continue oral anticoagulant.