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Results for “Postphlebitic Syndrome”

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PubMed2000

[Indication for surgical correction of venous hemodynamics in the occlusion stage of post-thrombophlebitic syndrome].

Complex examination of 73 patients with post-thrombophlebitic occlusion of iliac veins was performed. The regional venous hemodynamics indexes and the results of surgical treatment depended upon the disease duration. The indications for surgical correction of the pelvic venous hemodynamics disorders while presence of one-sided occlusion of iliac veins were substantiated.

Hemodynamics↗

PubMed1986

[Surgical treatment of sequelae of phlebitis].

Surgical indications in the post-phlebitic disease are supplied by an accurate physiopathologic analysis of the mentioned syndrome. Fuller research means such as: phlebography, functional explorations enable to demonstrate great pathogenic processes that could require a surgical treatment: venous obstruction can be treated thanks to a derivation treatment Palma-type. Various techniques have been proposed as for deep venous insufficiency. Surgical procedure of superficial venous insufficiency appeared as essential in operative indications. The major problem of such a procedure was the suppression of blood escape due to perforans veins insufficiency. There was no surgical treatment of postphlebitic disease, but rather surgical techniques that could be suited to particular conditions.

Humans↗

PubMed2002

[Role of plasminogen activators in the treatment of deep venous thrombosis].

In deep vein thrombosis, thrombolytic agents can improve vein patency more rapidly than conventional anticoagulant therapy. The clinical benefit of thrombolytic use would be a reduction in the incidence and severity of the postthrombotic syndrome and limb salvage in "phlegmatia caerulea". A literature review suggests that streptokinase and rt-PA do better than heparin regarding vein patency. A clinical benefit on postthrombotic syndrome can only be suggested by available evidence. The risk of major bleeding is increased by thrombolytic agents as compared with heparin. Mortality for cerebral bleeding is about 0.5%. Currently, thrombolytic therapy is only recommended for limb salvage in phlegmatia caerulea.

Cerebral Hemorrhage↗

PubMed2005

Post-thrombotic syndrome after total hip or knee arthroplasty: incidence in patients with asymptomatic deep venous thrombosis.

PURPOSE: To measure the risk of developing signs of post-thrombotic syndrome 15 to 24 months after total hip or knee arthroplasty in patients with asymptomatic deep venous thrombosis (DVT). METHODS: A total of 85 total knee arthroplasty patients and 47 total hip arthroplasty patients were postoperatively screened for asymptomatic DVT using colour duplex ultrasound. RESULTS: The rate of asymptomatic DVT was 37.6% (n = 32) in knee patients and 34.0% (n = 16) in hip patients. All 32 DVT cases in the knee group had thrombi located below the knee, whereas 6 of the 16 DVT cases in the hip group had thrombi located above the knee, the remaining 10 were below the knee. Patients with proximal thrombi were treated with warfarin for 3 months, whereas patients with distal DVT received 300 mg aspirin daily for the same period. All DVT cases were monitored for up to 12 weeks using repeated colour duplex scans. Signs of thrombus resolution were present at around 6 weeks (range, 4-12 weeks). Clot propagation was observed in 3 cases. In a mean of postoperative 18 months (range, 15-24 months), 28 of the 32 knee patients with asymptomatic DVT were available for follow-up: 11 had transient calf and ankle swelling, 6 had persistent oedema, and the remaining 11 were symptom free. 14 of the 16 hip patients with asymptomatic DVT were available for follow-up: 6 had transient calf and ankle swelling, 4 had persistent oedema, and 4 remained symptom free. 17 patients reported ongoing problems and were re-examined. Signs of mild-to-moderate post-thrombotic syndrome were recorded in 4 knee patients and 3 hip patients. CONCLUSIONS: Patients with above-knee DVT were much more likely to have post-thrombotic syndrome. Despite thromboprophylaxis with low-molecular-weight heparin, asymptomatic DVT is common after total joint arthroplasty and is responsible for the development of post-thrombotic venous insufficiency and post-thrombotic syndrome in a considerable proportion of patients. Once symptomatic or asymptomatic DVT is established, treatment appears incapable of preventing the occurrence of post-thrombotic syndrome, especially in cases of above-knee DVT. Efforts should hence concentrate on combating DVT propagation and improving DVT prevention.

Age Distribution↗

PubMed1994

Morphological and functional skin changes in postthrombotic syndrome.

After a period of deep venous thrombosis a lot of patients will develop chronic venous insufficiency. In time different skin alteration will occur. Several hypothesis have been proposed to explain the pathogenesis behind these skin changes. In this paper we will briefly discuss the most important theories. We concentrate on microcirculation and the different skin changes.

Atrophy↗

PubMed2004

The impact of venous thrombosis on quality of life.

Quality of life (QOL) is increasingly seen as an important outcome in clinical care. Etiology, diagnosis, and management of venous thrombosis have been studied extensively, but only few studies have examined the impact of venous thrombosis on quality of life. The purpose of this study was to examine the impact of venous thrombosis on quality of life in a well-defined population of patients with venous thrombosis, by using both a generic and a disease-specific quality of life measure. A total of 45 patients from the thrombosis clinic of the University of Vermont in Burlington, VT, returned a mailed questionnaire including the Short-Form 36 (SF-36) and a disease-specific venous thrombosis-quality of life (VT-QOL) questionnaire about the problems faced by patients with venous thrombosis. The sample consisted of 13 men (28.9%) and 32 women (71.1%). The mean age was 44.1 years, with a range from 21 to 80 years. Compared with population norms of a general U.S. population that were adjusted for age and sex (N= 2463), venous thrombosis patients scored significantly lower (p < 0.05) on all subscales of the SF-36. Patients with the postthrombotic syndrome (PTS) appeared to have more impairment in their quality of life as measured by both the SF-36 and the disease-specific questionnaire. All correlations between the SF-36 subscales and the subscales of the VT-QOL were significant, most of them on a p < 0.01 level. Given the impact of venous thrombosis and the postthrombotic syndrome on quality of life, assessment of QOL should be included in future studies on the outcome of venous thrombosis.

Adult↗

PubMed2006

Review on the value of graduated elastic compression stockings after deep vein thrombosis.

Graduated elastic compression stockings (GECS) are commonly used in the primary prevention of deep vein thrombosis (DVT); however, their role in preventing recurrent DVT and also post-thrombotic syndrome is less well established. The aim of this review was to investigate the effect of GECS after DVT. A literature search was performed by two independent searchers in order to identify randomised controlled trials on the effect of GECS in preventing recurrent DVT and post-thrombotic syndrome. Four randomised trials, including 537 patients, were identified. Two of the studies demonstrated that below-knee GECS significantly reduced post-thrombotic syndrome during follow-up, while a smaller study showed equivocal results. GECS reduced the incidence of post-thrombotic syndrome from 54% to 25.2% [relative risk (RR) 0.47, 95% confidence interval (CI) 0.36-0.61] with the number needed to treat (NNT) being 4 (95% CI 2.7-5.0). The rate of recurrent asymptomatic DVT was also significantly reduced by GECS (RR 0.20, 95% CI 0.06-0.64; NNT 5); the reduction in symptomatic DVT was not significant (RR 0.79, 95% CI 0.50-1.26; NNT 34). In conclusion, there is level Ia evidence to suggest that GECS can significantly reduce the incidence of post-thrombotic syndrome (PTS) after DVT, and therefore these should be routinely prescribed. The evidence for recurrent DVT is less conclusive. Further research is needed towards standardising PTS diagnostic criteria and evaluating more effective preventive measures after DVT.

Bandages↗

PubMed1994

[Clinical features in post-thrombotic syndrome].

Signs which follow deep vein thrombosis and which develop as a feature of deep venous insufficiency caused by incomplete recanalization and of destruction of valves and endothelium are defined as a postthrombotic syndrome. The clinical symptoms range between no objective signs, severe oedema and ulceration. They depend on the amount of valvular and endothelial damage during the acute phase, localization of the deep vein thrombosis and on several other factors outside the venous macrocirculation which are poorly understood until now.

Acrodermatitis↗

PubMed2000

[Treatment of trophic ulcers in chronic venous insufficiency using bio-transplants].

The results of treatment of 66 patients with trophic ulcer in postthrombophlebitic syndrome, using biological lining, manufactured from mollusc of Cephalopoda genus owing properties of semipermeable biological membrane, were analyzed. Application of biogenic linings had promoted the results of patients treatment improvement due to quickening of epithelization and formation of ripe granular tissue.

Aged↗

PubMed1992

[The significance of the functional status of the crural muscles in the pathogenesis of the postthrombophlebitic syndrome].

Venous stasis, disorders of oxygen metabolism and other disturbances in the post-thrombophlebitic syndrome result in reduction of the contractile function of the crus, i.e. muscle pumping capacity. Mutual influence of these factors result finally in the development of the so-called "vicious circle". Results of a study of 90 patients with different stages of the post-thrombophlebitic syndrome show a clear correlation between the stage of the disease and degree of reduction of the functional capacity of sural muscles. Measures for restoration of the contractile capacity of the crural muscles are advocated.

Adult↗

PubMed1994

[Relation between changes in the microcirculation in the capillaries supplying the toenails and the degree of chronic venous insufficiency].

Chronic venous insufficiency (CVI) is characterised by stasis which may lead to an imbalance in the cutaneous microcirculation resulting in a wide spectrum of complications. The use of capillaroscopy on the toenail folds of patients with CVI allows the morphological and microhemorrheological aspects of microcirculatory disorders to be studied. The aim of this study was to clarify the correlation between the extent of abnormalities of the nutritional capillary and the degree of severity of CVI according to Widmer's classification. Capillaroscopy of the toenail fold was used to study 100 patients suffering from essential varicose disease (EVD) and post-thrombotic syndrome (PTS) with CVI of various degrees, giving a total of 110 limbs grouped as follows: 30 limbs at stage 0; 49 at stage 1; 20 at stage 2 and 12 at stage 3. In addition, a further 30 limbs of normal subject without a family history of varicose disease were included in the study. All patients and control subjects were examined clinically and using ultrasound c.w. Doppler and eco-color-Doppler of the lower limbs. The results highlighted a progressive deterioration of the capillaroscopic conditions in relation to the severity of CVI. In particular, during stage 1 microcirculatory alterations found in patients with primary varicose syndromes appeared to be more severe than those with PTS. This apparent contradiction may be attributed to the unique topography of this hemodynamic disorders since the subpapillary circulation in EVD is topographically in direct continuity with the site of venous hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic Disease↗

PubMedDate not supplied

Robert May memorial lecture: Advances in reconstructive venous surgery.

During the last decade progress in reconstructive venous surgery is mainly based on improvements of preoperative diagnosis and on changed surgical techniques (e.g. intraoperative lumen control by vascular endoscopy or angiography; temporary arteriovenous fistulas as protective measure; external supported vascular prostheses as substitutes). The main indications include acute ilio-femoral phlebothrombosis, vein injuries and in selected cases the substitution of big veins in extended tumor surgery. The late results of venous thrombectomy in the ilio-femoral segment could be remarkably improved due to changed techniques of lumen restoration (combined ring- and balloon-disobliteration, temporary a.v. fistula in inguinal or popliteal position). In patients with persisting central occlusions in the iliac veins a second repair may be considered using a suprainguinal cross-over graft (external supported e-PTFE-prosthesis). For post-thrombotic syndrome with pronounced deep venous insufficiency reconstructive procedures afford a critical selection of patients (Palma-operation, Husni-May-operation, interposition of valve bearing venous segments in the superficial femoral vein). The remarkable contribution given by R. May to the advances in venous surgery is illustrated.

Blood Vessel Prosthesis↗

PubMed1993

The importance of the subfascial lymphatics in the diagnosis of lower limb edema: investigations with semiquantitative lymphoscintigraphy.

A new method of semiquantitative lymphoscintigraphy for the evaluation of lower limb edema is characterized by (1) the evaluation of both the epifascial and subfascial system in order to assess type and stage of the edema, (2) the use of high-resolution digital whole-body imaging to facilitate the calculation of functional parameters, and (3) the use of active, standardized ergometry for reproducibility. The appearance time of 99mTc-labeled human albumin nanocolloid in inguinal lymph nodes after injection and the percent uptake of colloid into lymph nodes at 40 and 120 min after injection served as functional parameters. Patients with edema of the lower limb were compared with normal subjects. In patients with primary lymphedema the two lymphatic compartments are functionally compromised. Early and advanced stages of postthrombotic syndromes can be distinguished by characteristic lymphoscintigraphic patterns in epifascial and subfascial lymphatic compartments. These results indicate that only the separate evaluation of both the epifascial and subfascial compartments allows an accurate functional assessment of the lymphatics in lower limb edema.

Adolescent↗

PubMedDate not supplied

[The indices of the humoral immunity status and its correction in acute drug allergy in patients with the postthrombophlebitic syndrome of the lower extremities].

The state of immunity was studied in 52 patients with the post-thrombophlebitic syndrome complicated by drug allergy. Levels of immunoglobulins G, A, M were found to be increased considerably in serum protein fractions. Series of medicamentous immunocorrective measures including removal of autoimmunoaggressive focus from altered area and surgical correction of venous blood circulation in damaged extremity was suggested.

Acute Disease↗

PubMed2002

The risk of postthrombotic syndrome in children with congenital heart disease.

The lower extremities of 28 unselected children with congenital heart disease were investigated and classified according to the criteria for postthrombotic syndrome five to ten years after their first cardiac catheterization. For the clinical criteria, all patients completed a questionnaire and underwent a standardized physical examination of both legs. For the pathophysiologic criteria, the presence of venous outflow obstruction and reflux was evaluated by color duplex sonography in 24 of the 28 patients. Mild postthrombotic syndrome was present in half the patients. Partial or complete occlusion of the investigated vein was found in four patients (17%). In all patients studied, the venous valves of the deep system were competent. Postthrombotic syndrome frequently occurs in children with congenital heart disease. Prospective studies seem to be justified to investigate the precise incidence and potential risk factors.

Anticoagulants↗

PubMed1990

[Pre- and postoperative treatment of trophic ulcers in a controlled germ-free environment].

Pre- and postoperative treatment was conducted in 140 patients with trophic ulcers in a controlled abacterial medium in the period from 1985 to 1988. The etiological factor of the development of the trophic ulcer was primary varicosity in 86 (61.4%) and the post-thrombophlebitic syndrome in 54 (38.5%) patients. Venous hemodynamics improved both on the healthy and on the affected extremity. Besides, there was a tendency towards a decrease of the blood proteolytic activity near the focus of affection and an increase of that in the peripheral blood.

Adult↗

PubMedDate not supplied

[Treatment of post-phlebitic syndrome].

The Authors report their experience in the treatment of the post phlebitic syndrome at ulceration stage. The therapy is based on three important points: a first medical treatment and later saphenous striping with a specific tying of the insufficient perforant veins to consolidate the results of scarification in the future; finally ther removal of plugs of fascia for the therapy of hypodermitis with a personal technique.

Bandages↗

PubMed2003

[Surgical treatment of chronic venous insufficiency in own material].

Nowadays most issues regarding venous disorders are described as chronic venous insufficiency (CVI)-which is defined as all symptoms that manifestate as impaired blood outflow from the lower limbs or in general the result of blood stasis in the deep and superficial venous system. Due to the fact that the symptomatology of venous diseases is wide, the treatment should be multioriented and often as well multi-specialized. The treatment of CVI needs a good understanding of the etiology of the primary insufficiency of the superficial and the deep venous systems. The main purpose of the surgical therapy is to remove the reflux in the great saphenous vein and the perforating veins. Additionally, during the surgical treatment the various veins should be removed in a way that gives the best cosmetic effect. In this article we presented the analysis of different surgical treatments in patients diagnosed with CVI 2-4 grade according to CEAP scale. The patients were hospitalized in our Clinic between april 1998 and april 2003. This group consisted of 311 patients, among them were 257 patients with primary varices, 25 patients with recurrent varices and 29 with postthrombotic syndrome. The choice of surgery was based on clinical examination and the result of venous USG. The most frequent (62%) surgical therapy was removal of the great saphenous vein with miniphlebectomy. To make the treatment more efficient we used the endoscopic method of obliteration of the insufficient perforating veins in lower limbs, called subfascial endoscopic perforating surgery (SEPS).

Angioscopy↗