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At least 37 records · Page 2Linked to original sources
PubMed1986

Distribution of venous valvular incompetence in patients with the postphlebitic syndrome.

The records of 122 patients who underwent Doppler evaluation for the postphlebitic syndrome were reviewed to determine the relationship between location of venous valvular incompetence and severity of clinical signs. Categorized according to the most severe physical finding, there were 35 limbs with perimalleolar ulcers, 113 with stasis pigmentation, 26 with swelling, and 70 with no overt signs. Incompetent veins, either deep or superficial, were present in 93% of the symptomatic and 59% of the asymptomatic limbs. Proximal (iliofemoral) deep venous incompetence was not strongly correlated with disease severity (p less than 0.10), but distal (popliteotibial) deep venous and superficial venous incompetence were (both, p less than 0.0005). The relative frequency of isolated proximal incompetence appeared to diminish with increasing disease severity; whereas that of distal incompetence, with or without associated proximal venous incompetence, increased. Isolated proximal venous incompetence was found in only 5% of limbs with severe disease (ulcers or pigmentation). In limbs with severe signs, distal venous incompetence was present in 67% of those with proximal venous incompetence and in 57% of those in which the proximal valves were competent. These findings cast doubt on the potential value of proximal venous valvular reconstruction, especially in limbs with combined proximal and distal insufficiency.

Adolescent↗
PubMedDate not supplied

[Some considerations on the postphlebitic syndrome].

After a brief description of the aetiopathogenetic aspects of the phlebitic and postphlebitic syndrome, medical and surgical therapies for this syndrome are reviewed. A derivative of the phenybutazone group (Febutol) is then discussed and its considerable effectiveness emphasized.

Anticoagulants↗
PubMedDate not supplied

The effects of heparin and oral anticoagulants on thrombus propagation and prevention of the postphlebitic syndrome: a critical review of the literature.

Based on a comprehensive literature search, this report aims to examine the effects of heparin and oral anticoagulants on thrombus propagation and prevention of the postphlebitic syndrome. The effects on recurrence of thromboembolic disease have not been addressed. It is concluded that published reports of serial venograms and ultrasound examinations of patients treated with conventional anticoagulant therapy for deep venous thrombosis show either no change or thrombus extension in the first few months in approximately 50% of cases. Approximately two thirds of patients will have damage to the venous valves, leading to incompetence or other hemodynamic changes. More than one third of patients so treated may have oedema, leg pain, or other severe symptoms on long-term follow-up. The consistency with which these outcomes have been observed, particularly in many large, recent, prospective trials, adds to the credibility of these figures. The results of prospective controlled trials have failed uniformly to show any significant local benefits of anticoagulant therapy for deep vein thrombosis compared with other treatments or placebo. There does not seem to be any convincing evidence that heparin exerts a favorable influence on pulmonary embolism in situ or on portal vein thrombosis. Use of anticoagulant therapy to limit thrombus propagation therefore cannot be said to be "evidence based." These generally poor outcomes with regard to postphlebitic complications should lead to an active exploration of alternative methods of management. Substantial uncertainties surrounding many fundamental aspects of the treatment of this disease remain, and further placebo-controlled trials are needed.

Anticoagulants↗
PubMedDate not supplied

[A case of multiple arteriovenous fistulae in a postphlebitic syndrome of longterm evolution].

Authors report a case of a 77-years-old man who, after an accident of traffic on 1968, presented a left ileo-femoral deep venous thrombosis. Consequently, the patient suffered and important postphlebitic syndrome, with several varicose packs which were treated by surgical procedure in other centre. During several years, patient presented severe trophic diseases. Seventeen years after the beginning of his pathology, and during an angiologic examination, multiple arteriovenous fistulas at the left ileofemoral area have been shown. An skeletalization was impossible because of the severe ulcerations of the leg; so a left iliac arterial ligature and a Dacron Banding in primitive iliac artery, reducing a 50% the diameter, were made. The postoperative result was excellent, with an spectacular reduction of the fistulous communications and a complete remission of the cutaneous ulcerations.

Accidents, Traffic↗
PubMedDate not supplied

[Arteriovenous fistula in patients with a complicated postphlebitic syndrome].

An investigation, which goal is to evidencing AV fistulas in patients with a complicated postthrombotic syndrome, as well as to determinate the efficacy of noninvasive methods used for the study of AV fistulas in such patients, is presented. So, patients with a complicated postphlebitic syndrome interned into the Instituto de Angiología were studied. Twenty-five patients were included in the study, 9 of these patients (36%) had arteriovenous fistulas, arteriographically evidenced. Haemodynamic study do not support the evidence of such communications.

Arteriovenous Fistula↗
PubMed1987

The postphlebitic syndrome following shaft fractures of the leg. A significant late complication.

Sixty patients each of whom had a fracture of the lower limb a minimum of five years (median 11 years) previously were studied by photoplethysmography, foot volumetry, popliteal venous reflux and arterial Doppler measurements. The non-fractured limb was used as a control. Postphlebitic symptoms were present in 51% and signs in 49% of fractured limbs compared with 4% and 24% respectively in the control limbs. The incidence was greater in patients who had fractured 15 years or more previously than in those who had fractured 5 to 15 years previously. Eleven limbs had clinically disabling postphlebitic symptoms including venous ulceration. The postphlebitic syndrome following lower limb fractures in young patients is more common than generally appreciated and develops after a prolonged latent interval. A prospective randomised study using prophylactic anticoagulation for lower limb shaft fractures may be justified.

Adolescent↗
PubMedDate not supplied

Haemodynamics of the postphlebitic syndrome.

The venous function has been assessed after deep vein thrombosis (DVT) by Doppler, strain gauge plethysmography (55 patients) and exercise plethysmography (10 patients) for a mean period of 63 weeks. Venous volume and venous outflow remain significantly lower throughout the study, whatever the site of thrombosis and the initial therapy (Heparin, local or general Urokinase). There are no significant correlations between clinical and functional parameters except for patients with proximal obstruction and popliteal valvular incompetence. Exercise plethysmography evaluates the importance of the calf pump in the postphlebitic syndrome. Static plethysmographic measurements prove to be unreliable for the long term prognosis whereas associated dynamic tests should be a better way to assess the haemodynamic changes after DVT and to control the efficiency of the prevention of the post-phlebitic syndrome.

Adult↗
PubMed1983

Pathogenesis of the postphlebitic syndrome.

The dependent edema, skin pigmentation, local inflammation associated with subcutaneous fibrosis, chronic ulceration, and current infection are the hallmarks of postphlebitic syndrome. In one fifth of the patients there is no evidence of antecedent deep venous occlusion. Current emphasis is therefore on improvement in investigation and the use of treatment programs designed to return venous patency and valve function to normal. Modern management must also take into account local changes in capillary permeability and fibrinolytic activity in the pathogenesis of the venous ulceration.

Edema↗
PubMed1984

The postphlebitic syndrome. Pathophysiology, prevention and management.

Chronic deep venous insufficiency of the lower extremity, usually the result of antecedent venous thrombosis, represents a problem of considerable magnitude for both patient and physician. While the fully developed postphlebitic syndrome is immediately recognized by the most inexperienced medical student, the exact underlying pathogenetic mechanisms remain controversial, available therapeutic options are limited, and the value of surgery is uncertain.

Chronic Disease↗