• Jacob Michael Lurie, C Y Maximilian Png, Sneha Subramaniam, Sida Chen, Emily Chapman, Aiya Aboubakr, Michael Marin, Peter Faries, and Windsor Ting.
• Mount Sinai Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: jacob.lurie@icahn.mssm.edu.
• J Vasc Surg Venous Lymphat Disord. 2019 Sep 1; 7 (5): 640-645.

ObjectiveWhile determining the incidence of chronic deep vein thrombosis (DVT) and the hypercoagulation profiles of patients who underwent venous stenting for symptomatic venous insufficiency, we assessed the significance of Virchow's triad in the setting of proximal venous outflow obstruction and DVT.MethodsWithin our registry of 500 patients who underwent venous stenting for proximal venous outflow obstruction between 2013 and 2016, we selected the first 152 consecutive patients who had routine hypercoagulation profile testing performed preoperatively. Statistical analysis was performed using independent t-tests, χ2 tests, and multiple logistic regressions.ResultsBy history or intraoperative chronic postphlebitic changes (CPPCs), 77 patients (50.7%) were positive for remote DVT; 51 (33.6%) had intraoperative findings of CPPCs without a history of DVT, 20 (13.2%) had intraoperative CPPCs with a history of DVT, and 6 (3.9%) had a history of DVT without intraoperative findings. The χ2 tests were significant for increased findings of CPPCs among patients with a history of DVT (81% vs 38%; P < .01). The χ2 tests were also significant for increased rates of intraoperative findings of CPPCs in patients with one or more positive hypercoagulation markers (67% vs 42%; P < .01). The most significant predictor for findings of CPPCs or DVT history was the presence of at least one hypercoagulation marker (n = 148; odds ratio, 2.41; P = .022).ConclusionsRemote history of DVT and intraoperative findings of CPPCs were prevalent. CPPC findings were found in many patients with no history of DVT. Hypercoagulation markers conferred significant predictive value for DVT. This information may influence our understanding of Virchow's triad and DVT etiology.Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

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