Long-term consequence of asymptomatic thrombosis in children

Introduction. Over the past 10 years, there has been a 130 % increase in the amount of thrombosis in hospitalized children. The data about frequency, outcomes and long-term complications of incidental thrombosis is usually presented together with symptomatic thrombosis, and the problem of asymptomatic thrombosis seems to be underestimated.

Aim to the study – to assess the patient-related characteristics, outcomes of incidental thrombosis in children. To estimate the frequency, severity and risk factors of post-thrombotic syndrome (PTS) after incidental thrombosis. To evaluate the effect of therapy on thrombus resolution and frequency of PTS following asymptomatic deep vein thrombosis (DVT) in children.

Materials and methods. We have retrospectively analyzed the medical records of 48 patients from 0 to 17 years (at the time of thrombosis) from 2013 to 2023 of our tertiary care Centre with objectively confirmed asymptomatic DVT of upper or lower extremity. All patients were divided into 2 groups: patients, who did not receive antithrombotic treatment (G1) and who assessed therapy (G2). Then we analyzed the data of PTS assessment in these patients. PTS was measured using Manco–Jonson Instrument (MJI), Modified Villalta Scale (MVS), the Clinical Assessment of Post-Thrombotic Syndrome (CAPTSure). Chi-square test was used to assess the statistical significance of differences between groups.

Results. 90 % of patients were cancer patients, most of DVTs (96 %) were in the veins of upper extremity, 27 % of thrombosis were occlusive. There were no statistically significant differences between G1 and G2 in thrombus resolution, severity and frequency of PTS. The overall frequency of PTS was 46 % using MVS/MJI and 29 % using CAPTSure. Majority of children had mild PTS, the most common symptom was the presence of collaterals. There was 1 patient with moderate PTS in G2.

Conclusion. The overall frequency of PTS in patients with asymptomatic thrombosis was 46 %. However, most patients had mild PTS and slight clinical sings. There were no statistically significant difference in the rate of recanalization at 3 months after thrombosis between patients who received anticoagulant therapy and those who did not. Also, there were no statistically significant differences in the frequency and severity of PTS between groups.

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