PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Postphlebitic Syndrome”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

Development of the postthrombotic syndrome: its management at different stages.

The postthrombotic syndrome consists of clinical features which follow thrombosis of deep venous return of the limb. Patterns of postthrombotic changes remain difficult to predict and once established, difficult to contain and reverse. Following a thrombotic event of the lower limb, 3 clinical stages can be observed which may be followed by intervening quiescent intervals. Stage I, or the early phase, is characterized by the residual obstructive process following acute venous occlusion. This can be manifested by either a bursting type of pain (venous claudication) or edema of the leg. A thrombotic process can involve the calf veins, thigh veins, pelvic veins, or any combination of the three. Specific clinical syndromes develop depending on the venous pump system involved. The venous pump system consists of the plantar calf pump and the thigh pump. These serve to propel blood upward. Involvement of any one or more of the 3 in the thrombotic processes can result in a relative obstruction with a specific pattern of clinical symptoms. Optimally, the venous thrombotic process should be treated during this early phase to prevent the subsequent events which may render the process irreversible. The second stage of the postthrombotic syndrome consists of the development of fat sclerosis. At this stage, the process becomes progressively irreversible as the extravasation of fibrin into the interstitial space results in progressive fibrosis and sclerosis. This results in damage to the skin and subcutaneous tissues which render the process irreversible. Specific treatment, while still introducible at this stage, can halt the progress of the syndrome, but rarely results in complete reversal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed2004

Non-pharmaceutical measures for prevention of post-thrombotic syndrome.

BACKGROUND: Post-thrombotic syndrome (PTS) is a long-term complication of deep vein thrombosis (DVT) characterised by chronic pain, swelling and skin changes in the affected limb. One in every three patients with DVT will develop post-thrombotic complications within five years. OBJECTIVES: To determine the relative effectiveness of, and the rate of complications using non-pharmaceutical interventions in patients with DVT in the prevention of PTS. SEARCH STRATEGY: The reviewers searched the Cochrane Peripheral Vascular Diseases Group Specialised Trials Register (last searched January 2003), and the Cochrane Central Register of Controlled Trials (CENTRAL) (last searched Issue 4, 2002). In addition, hand searching of non-listed journals and personal communications with researchers was undertaken. SELECTION CRITERIA: Randomised controlled trials (RCTs) of non-pharmaceutical interventions, such as bandaging and elastic stockings in patients with clinically confirmed DVT. The primary outcome was the occurrence of PTS. There was no restriction on date or language. One reviewer (DNK) identified and assessed titles and abstracts for relevance. This was verified independently by a second reviewer (RS). DATA COLLECTION AND ANALYSIS: Data extraction was undertaken independently by two reviewers (DNK, RS), using data extraction sheets. MAIN RESULTS: Three RCTs that evaluated compression therapy were identified. Two studies compared elastic compression stockings with a pressure of 30-40 mm Hg at the ankle with no intervention applied directly after an episode of DVT. The other small study compared elastic compression stockings (pressure 20-30 mm Hg) with stockings that were one to two sizes too large in patients one year after DVT. Overall, in the treatment group at two years, the use of elastic compression stockings was associated with a highly statistically significant reduction in the incidence of PTS with odds ratio (OR) 0.31 (95% confidence interval (CI) 0.20 to 0.48). In addition, the incidence of severe PTS was reduced from OR 0.39 (95% CI 0.20 to 0.76). In another RCT that considered the first nine days post DVT, no difference in the incidence of pulmonary embolism and size of thrombus in the femoral vein was found. A statistically significant reduction (p <0.05) was found in pain, swelling and clinical scores, favouring the compression group. REVIEWER'S CONCLUSIONS: There is substantial evidence that elastic compression stockings reduce the occurrence of PTS after DVT. No serious adverse effects were mentioned in the studies. Hence, elastic compression stockings should be added to the treatment of DVT to prevent the development of post-thrombotic syndrome.

Bandages↗
PubMed1995

[Ultrasound diagnosis in post-thrombotic syndrome. Comparative study with color duplex, cw-Doppler and B-image ultrasound].

UNLABELLED: Comparison of colour-coded Doppler sonography, CW-Doppler and real time sonography in the diagnostics of the postthrombotic syndrome. METHOD: Colour-coded Doppler sonography, CW-Doppler and real time sonography were studied in 40 legs with postthrombotic syndrome, confirmed by phlebography. In a further step deep veins of patients with primary varicosis (n = 40) and a group of normal veins (n = 40) where compared with the postthrombotic group (n = 40). RESULTS: The sensitivity of CW-Doppler was 71.2% and that of real time sonography 67.5%, their specificity 92.3% and 92.2%, respectively, while colour-coded Doppler sonography had a sensitivity of 90.9% and a specificity of 88.9%. In addition, colour-coded Doppler sonography in combination with measurement of the peak velocity of venous reflux in deep veins had the highest sensitivity with 92.8% and specificity with 95.4% of all ultrasound methods tested. By means of colour-coded Doppler sonography together with measurement of the peak velocity of venous reflux, healthy persons and patients with varicosis could be distinguished with high significance (p < 0.003) by a peak velocity of venous reflux of more than 10 cm/s. CONCLUSION: In comparison to real time sonography and CW-Doppler, quantitative analysis of reflux in the deep veins by means of colour-coded Doppler sonography is the most valid ultrasound method in the diagnosis of postthrombotic syndrome.

Blood Flow Velocity↗
PubMed1998

[Quality assurance in phlebography of the extremities. German Societies for Angiology and Phlebology and Vascular Surgery].

By interdisciplinary cooperation with the German Societies for Angiology, Phlebology and Vascular Surgery, recommendations have been worked out which address the indication of phlebography of the veins of the extremities and which define the quality standards of phlebographic techniques. The specific clinical questions in varicose syndrome acute thrombosis and postthrombotic syndrome have to be answered by employing adequate phlebographic technique, documentation, and description of relevant morphologic and functional findings.

Angiography↗
PubMed1991

Venous tone: are the phlebotonic properties predictive of a therapeutic benefit? A comprehensive view of our experience with Daflon 500 mg.

Venodilation has been shown to enhance clinical expression of venous insufficiency and, therefore, it has been suggested that increase of venous tone should improve clinical symptoms. Four controlled double-blind clinical trials versus placebo, or versus a new micronized flavonoid fraction, have shown the activity of Daflon 500 mg, which has been evaluated on venous tone using venous plethysmography. The first, randomized cross-over Phase II pharmacoclinical trial has shown that Daflon 500 mg is significantly more effective than placebo on pathological legs, as well as normal legs. In this study, which included 20 patients suffering from post-thrombotic syndrome. Daflon 500 mg decreased: 1) venous capacity (p less than 0.001); 2) venous distensibility (p less than 0.001); and 3) venous outflow time, measured by the two parameters: total emptying venous time (p less than 0.001) and T2p (p less than 0.001). These modifications were observed 2 h after administration without any significant change in T50 outflow, cardiac index, capillary filtration index, blood pressure, cardiac or respiratory rates. The same acute effect of increasing venous tone has been demonstrated in another pharmaco-clinical trials, 1 and 2 h after ingestion by three groups, each composed of 10 women suffering from venous insufficiency: group I without varicose veins, group II during pregnancy, and group III with a post-thrombotic syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Diosmin↗