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Thromb Haemost 1997; 77(06): 1109-1112
DOI: 10.1055/s-0038-1656121
Clinical Studies
Schattauer GmbH Stuttgart

On the Relationship between Changes in the Deep Veins Evaluated by Duplex Sonography and the Postthrombotic Syndrome 12 Years after Deep Vein Thrombosis

U K Franzeck
The Department of Medicine, Division of Vascular Medicine, University Hospital, Zürich, Switzerland
,
I Schalch
The Department of Medicine, Division of Vascular Medicine, University Hospital, Zürich, Switzerland
,
A Bollinger
The Department of Medicine, Division of Vascular Medicine, University Hospital, Zürich, Switzerland
› Institutsangaben
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Publikationsverlauf

Received 04. Dezember 1996

Accepted after revision 17. Februar 1997

Publikationsdatum:
12. Juli 2018 (online)

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Summary

In a prospective study we performed color duplex ultrasonography to evaluate patency and valvular function of previous thrombosed veins 12 years after the acute thrombosis.

Normal clinical findings were found in 64% of the patients, mild postthrombotic skin changes in 28%, and marked trophic changes in 5%; only 1 venous ulcer occurred.

In 39 patients, 114 initially thrombosed vein segments were evaluated. Thirty-seven of 72 proximal segments were completely recanalized (23 with valvular incompetence) and 21 segments exhibited partial recanalization (19 with valvular incompetence). Superficial femoral vein segments were completely occluded in 19%, however, excellent collateralization was provided via the deep femoral vein. Thromboses of the posterior tibial vein demonstrated a high rate of recanalization with development of valvular incompetence in 52%.

Whereas obstruction and valvular incompetence as single factors led to a postthrombotic leg in 8.5% and 33%, respectively, the most frequent cause for the development of the postthrombotic syndrome was the combination of reflux plus obstruction in the deep veins (50%).

Compression therapy with elastic compression stockings is recommended for at least 5 years after the acute thrombosis.

 

  • References

  • 1 Franzeck UK, Schalch I, Jäger K, 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 (Zürich study). Circulation 1996; 93: 74-79
    CrossrefPubMedSuche in Google Scholar
  • 2 Widmer LK, Stähelin HB, Nissen C, da SilvaA, Ven en, Arterien krankheiten, koronare Herzkrankheitbei Berufstätigen. Prospektiv-epidemiologische Untersuchung. Basle Study I-III. Bern: Huber Verlag; 1981
    Suche in Google Scholar
  • 3 Porter JM, Moneta G. and An International Consensus Committee on Chronic Venous Disease. Reporting standards in venous disease: an update. J Vase Surg 1995; 21: 635-645
    CrossrefPubMedSuche in Google Scholar
  • 4 Killewich LA, Bedford GR, Beach K, Strandness Jr DE. Spontaneous lysis of deep venous thrombi: rate and outcome. J Vase Surg 1989; 09: 89-97
    CrossrefPubMedSuche in Google Scholar
  • 5 Franzeck UK, Bollinger A, Huch R, Huch A. Transcutaneous oxygen tension and capillary morphologic characterstics and density in patients with chronic venous incompetence. Circulation 1984; 70: 806-811
    CrossrefPubMedSuche in Google Scholar
  • 6 Johnson BF, Manzo RA, Bergelin MS, Strandness Jr DE. Relationship between changes in the deep venous system and the development of the postthrombotic syndrome after an acute episode of lower limb deep vein thrombosis: a one- to six-year follow-up. J Vase Surg 1995; 21: 307-313
    CrossrefPubMedSuche in Google Scholar
  • 7 Browse NL, Clemenson G, Thomas ML. Is the postphlebitic leg always post- phlebitic? Relation between phlebographic appearances of deep-vein thrombosis and late sequelae. Br Med J 1980; 281: 1167-1170
    CrossrefPubMedSuche in Google Scholar