The Post-thrombotic Syndrome in Young Women: Retrospective Evaluation of Prognostic Factors

Eugenia Biguzzi; Enrico Mozzi; Adriano Alatri; Emanuela Taioli; Marco Moia; Pier Mannuccio Mannucci

doi:10.1055/s-0037-1615423

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1998; 80(04): 575-577
DOI: 10.1055/s-0037-1615423

Rapid Communication

Schattauer GmbH

The Post-thrombotic Syndrome in Young Women: Retrospective Evaluation of Prognostic Factors

Eugenia Biguzzi

¹From the “Angelo Bianchi Bonomi” Hemophilia and Thrombosis Center

,

Enrico Mozzi

²From the Institute of General and Oncologic Surgery

,

Adriano Alatri

¹From the “Angelo Bianchi Bonomi” Hemophilia and Thrombosis Center

,

Emanuela Taioli

³From the Epidemiology Unit, IRCCS Maggiore Hospital and University of Milan, Milan, Italy

,

Marco Moia

¹From the “Angelo Bianchi Bonomi” Hemophilia and Thrombosis Center

,

Pier Mannuccio Mannucci

³From the Epidemiology Unit, IRCCS Maggiore Hospital and University of Milan, Milan, Italy

› Author Affiliations

Abstract

Summary

Post-thrombotic syndrome (PTS) in young women may cause impairment in the quality of life of otherwise healthy people. We aimed to evaluate the prevalence of PTS and its risk factors in young women.

We evaluated 51 women with at least one previous episode of symptomatic, objectively documented deep vein thrombosis (DVT) before the age of 40. Each patient asked for symptoms had a physical examination, a color-coded Doppler ultrasonography of the superficial and deep venous system and an extensive laboratory evaluation for the congenital and acquired coagulation abnormalities predisposing to thrombosis. The median follow-up was 47 months.

PTS was absent in 37%, mild in 55%, moderate in 4% and severe in 4% of patients. No correlation was found between PTS and the presence of coagulation abnormalities, triggering factors, recurrences, use of elastic stockings for one year after DVT, degree of recanalization, presence of superficial reflux. Patients with a body mass index (BMI) >22 had an adjusted ratio of 4.7 (98 CI: 1.0-23.3) of developing the PTS. Though severe and moderate PTS are rare, mild PTS is present in the majority of young women after DVT. A BMI >22 is associated to the risk of developing PTS. Attempt to control weight in women after DVT should be considered and studied to prevent PTS.

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References

References
1 Hirsh J. Management of deep vein thrombosis and pulmonary embolism. A statement for healthcare professionals.. Circulation 1996; 93: 2212-45.
2 Prandoni P, Lensing AWA, Cogo A, Cuppini S, Villalta S, Carta M, Cattelan AM, Polistena P, Bernardi E, Prins M. The long-term clinical course of acute deep vein thrombosis.. Ann Intern Med 1996; 125: 1-7.
3 Gjores JE. The incidence of venous thrombosis and its sequelae in certain districts of Sweden.. Acta Chir Scand 1956; 206 (Suppl. 01) 1-88.
4 Strandness Jr DE, Langlois Y, Cramer M, Randlett A, Thiele BL. Long-term sequelae of acute venous thrombosis.. JAMA 1983; 250: 1289-92.
5 Widmer LK, Zemp E, Widmer MT, Schmitt HE, Brandemberg E, Voelin R, Biland L, da Silva A, Maggs M. Late results in deep vein thrombosis of the lower extremity.. Vasa 1985; 14: 264-8.
6 Kakkar VV, Lawrence D. Hemodynamic and clinical assessment after therapy for acute deep vein thrombosis.. Am J Surg 1985; 150: 54-63.
7 Lindner DJ, Edwards JM, Phinney ES, Taylor Jr LM, Porter JM. Long-term hemodynamic and clinical sequelae of lower extremity deep vein thrombosis.. J Vasc Surg 1986; 4: 436-62.
8 Heldal M, Seem E, Sandset PM, Abildgaard U. Deep vein thrombosis: a 7-year follow-up.. J Intern Med 1993; 234: 71-5.
9 Johnson BF, Manzo RA, Bergelin RO, Strandness DE. Relationship between changes in the deep venous system and the development of the post-thrombotic syndrome after an acute episode of the lower limb deep vein thrombosis: a one to six year follow up.. J Vasc Surg 1995; 21: 307-13.
10 Franzeck UK, Schalch I, Jäger KA, Schneider E, Grimm J, Bollinger A. Prospective 12-year follow-up study of clinical and hemodynamic sequelae after deep vein thrombosis in low-risk patients (Zurich study).. Circulation 1996; 93: 74-9.
11 Salzman EW, Hirsh J. The epidemiology, pathogenesis and natural history of venous thrombosis.. In: Colman RW, Hirsh J, Marder VJ, Salzman EW. eds. Haemostasis and Thrombosis: Basic Principles and Clinical Practice.. Philadelphia:: JB Lippincott; 1993: 1275-96.
12 Rabinov K, Paulin S. Roengten diagnosis of venous thrombosis in the leg.. Arch Surg 1972; 104: 134-44.
13 Prandoni P, Cogo A, Bernardi E, Villalta S, Polistena P, Simioni P, Noventa F, Benedetti L, Girolami A. A simple ultrasound approach for detection of recurrent proximal-vein thrombosis.. Circulation 1993; 88 [part 1] 1730-5.
14 Porter JM, Rutherford RB, Clagett GP, Cranley JJ, O’Donnell TF, Seshari R, Zierler RE, Browse N, Nicolaides A. Reporting standards in venous disease.. J Vasc Surg 1995; 21: 635-45.
15 Brandjes DPM, Büller HR, Heijboer H, Huisman MV, de Rijk M, Jagt H, ten Cate JW. Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis.. Lancet 1997; 349: 759-62.
16 Franzeck UK, Schalch I, Bollinger A. On the relationship between changes in the deep veins evaluated by duplex sonography and the post-thrombotic syndrome 12 years after deep vein thrombosis.. Thromb Haemost 1997; 77: 1109-12.