Document Detail

The risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. The DURAC Trial Study Group.
MedLine Citation:
PMID:  10810000     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To investigate the risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. DESIGN: An open prospective long term follow-up multicentre trial. Patients were followed by frequent outpatient visits at each centre during the first 12 months after inclusion and thereafter annually. SETTING: Sixteen hospitals in central Sweden. SUBJECTS: A total of 790 consecutive patients with objectively verified first episode of acute deep vein thrombosis and without diagnosed malignant disease were recruited from a randomized study comparing 6 weeks with 6 months of oral antivitamin K therapy as secondary thromboprophylaxis. MAIN OUTCOME MEASURES: Deep vein thrombosis in the contralateral leg was confirmed by venography or ultrasound. With regard to the ipsilateral leg, venography was required. RESULTS: A recurrent episode of venous thromboembolism was documented in 192 patients after a mean (+/-SD) period of 31(+/-29) months. In 26 additional patients with ipsilateral symptoms the diagnostic critera were not fulfilled. One hundred and eleven patients have deceased and 69 patients withdrew from the study. The 392 patients without recurrent episodes were followed for a median of 96 months with 90% for at least 48 months. An objectively verified recurrent contralateral and ipsilateral deep vein thrombosis occurred in 95 and 54 cases, respectively, and in 41 patients pulmonary embolism was documented. In two patients thromboses with unusual locations were registered. The risk of contralateral versus ipsilateral recurrence was significantly increased with a risk ratio of 1.6 (95% confidence interval 1.4-1.9) in a time to event model. In a multivariate analysis none of the investigated variables were significantly associated with the side of recurrent thrombosis. CONCLUSIONS: The risk of a recurrent deep vein thrombosis is increased in the contralateral leg. This brings into question the importance of an impaired venous flow for recurrent episodes of thrombosis.
P Lindmarker; S Schulman
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of internal medicine     Volume:  247     ISSN:  0954-6820     ISO Abbreviation:  J. Intern. Med.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-06-19     Completed Date:  2000-06-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  601-6     Citation Subset:  IM    
Department of Haematology, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden.
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MeSH Terms
Data Interpretation, Statistical
Follow-Up Studies
Leg / blood supply*
Longitudinal Studies
Middle Aged
Prospective Studies
Pulmonary Embolism / epidemiology,  prevention & control
Treatment Outcome
Venous Thrombosis / diagnosis,  epidemiology*,  physiopathology,  prevention & control*
Vitamin K / antagonists & inhibitors
Reg. No./Substance:
12001-79-5/Vitamin K

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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