Research and practice in thrombosis and haemostasis · 2026
Early venous thrombus resolution in neonates/infants: retrospective review of a 20-year single institution experience.
СтатьяНазвание и аннотация: Перевод в очереди
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Yan Elizabeth, Bauman Mary, Meakins Leanne, Bruce Aisha, Livingston Joel
Аннотация
BACKGROUND: Due to differences in developmental hemostasis, the management of neonatal and infant venous thromboembolism requires special consideration compared with adults and even older children. The benefits of anticoagulation to optimize thrombus resolution and prevent recurrence need to be balanced with the risks of bleeding, and recent studies support shorter courses of anticoagulation treatment for children.
OBJECTIVES: Review outcomes of neonatal (age ≤28 days) and young infant (age ≤3 months) thrombi treated at a single institution over a 20-year period with the standard practice of performing an ultrasound at 2 to 4 weeks postdiagnosis and discontinuing anticoagulation with thrombus resolution.
METHODS: All deep vein thrombosis (DVT) diagnosed in patients ≤3 months of age between October 2003 and January 2025 were reviewed retrospectively, with arterial, superficial vein, portal vein, and/or renal vein thrombi excluded.
RESULTS: A total of 151 patients met criteria (neonates = 79 and young infants = 72), and 179 DVTs were identified. The median resolution time was 28 (IQR, 13-60) days, with a significant proportion of thrombi resolving by 2 (16.8%) and 4 (28.5%) weeks, respectively. DVTs that were more likely to resolve early included those affecting the upper limb and those that were initially partially occlusive. No significant differences in venous thromboembolism resolution were observed between cardiac versus noncardiac patients. Post-DVT treatment, the 1-year recurrence rate was low at 3.4%.
CONCLUSION: These findings suggest a significant proportion of DVT in children aged ≤3 months of age may resolve within 2 to 4 weeks postdiagnosis, and ultrasound screening in this timeframe may be useful in limiting anticoagulation duration to reduce potential bleeding risks.
OBJECTIVES: Review outcomes of neonatal (age ≤28 days) and young infant (age ≤3 months) thrombi treated at a single institution over a 20-year period with the standard practice of performing an ultrasound at 2 to 4 weeks postdiagnosis and discontinuing anticoagulation with thrombus resolution.
METHODS: All deep vein thrombosis (DVT) diagnosed in patients ≤3 months of age between October 2003 and January 2025 were reviewed retrospectively, with arterial, superficial vein, portal vein, and/or renal vein thrombi excluded.
RESULTS: A total of 151 patients met criteria (neonates = 79 and young infants = 72), and 179 DVTs were identified. The median resolution time was 28 (IQR, 13-60) days, with a significant proportion of thrombi resolving by 2 (16.8%) and 4 (28.5%) weeks, respectively. DVTs that were more likely to resolve early included those affecting the upper limb and those that were initially partially occlusive. No significant differences in venous thromboembolism resolution were observed between cardiac versus noncardiac patients. Post-DVT treatment, the 1-year recurrence rate was low at 3.4%.
CONCLUSION: These findings suggest a significant proportion of DVT in children aged ≤3 months of age may resolve within 2 to 4 weeks postdiagnosis, and ultrasound screening in this timeframe may be useful in limiting anticoagulation duration to reduce potential bleeding risks.