ORIGINAL ARTICLES  VASCULAR PAPERS 

The Journal of Cardiovascular Surgery 2000 June;41(3):441-6

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

The occurrence of the post-thrombotic changes after an acute deep venous thrombosis. A prospective two-year follow-up study

Saarinen J., Kallio T., Lehto M., Hiltunen S., Sisto T.

From the Department of Surgery *Department of Radiology Tampere University Hospital, Tampere, Finland

Background. The aim of the ­study is to inves­ti­gate the devel­op­ment of sub­jec­tive and objec­tive find­ings dur­ing the ­first two ­years ­after DVT (­deep ­venous throm­bo­sis).
Methods. This pros­pec­tive two-­year fol­low-up ­study was estab­lished in Tampere University Hospital in Finland. Twenty-six ­patients ­with a two-­year fol­low-up ­after a phleb­o­graph­i­cal­ly con­firmed DVT ­were fol­lowed. Patients ­were treat­ed con­ven­tion­al­ly ­with hep­ar­in and war­far­in. Phlebo-graphy was repeat­ed 7 ­months ­after DVT. Color-­flow ­duplex imag­ing (­CFDI) was per­formed in ­both ­legs 7 and 20 ­months ­after DVT. The sub­jec­tive symp­toms in ­both ­legs ­were record­ed at the begin­ning and at the end of the fol­low-up. The devel­op­ment of ­venous ­reflux, obstruc­tion and sub­jec­tive symp­toms ­after DVT ­were stud­ied.
Results. 50% of the ­legs ­with DVT had a path­o­log­i­cal (deep ­reflux or obstruc­tive ­change) ­CFDI-find­ing in the pop­li­teal seg­ment ­after a 20-­month fol­low-up. The path­o­log­i­cal find­ings in the con­trol ­legs ­were ­rare. The ­rate of rec­a­nal­isa­tion was ­high. There was no dif­fer­ence ­between ­calf and ­more prox­i­mal DVTs. Pain (62%), oede­ma (46%) and pig­men­ta­tion (35%) ­were com­mon and ­only 27% of the ­legs ­with DVT ­were asymp­to­mat­ic.
Conclusions. The devel­op­ment of the post-­throm­bot­ic syn­drome ­begins ­quite ear­ly. The fre­quen­cy of the sub­jec­tive symp­toms is ­high. Calf DVT may ­lead to post­throm­bot­ic seque­lae in the pop­li­teal seg­ment.