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An Objective Assessment of the Physiologic Changes in the Postthrombotic Syndrome

An Objective Assessment of the Physiologic Changes in the Postthrombotic Syndrome Abstract • To determine what physiologic changes might contribute to the development of the postthrombotic syndrome, venous outflow, venous refilling time, and valvular competence were assessed in 32 patients (39 limbs) with documented deep venous thrombosis. The follow-up ranged from nine to 144 months (mean, 41 months) after the acute deep venous thrombosis. Pain was noted by 49% of the patients, but more objective end points occurred less frequently (edema, 21%; pigmentation, 26%; ulceration, 3%). Venous outflow was lower in the affected limbs but was not a good indicator of those patients with or without symptoms. Venous refilling time after calf compression was markedly reduced in limbs with incompetent valves (mean ± SD, 8.4 ± 3.8 s v 25.3 ±12.1 s), as well as in those with edema, pigmentation, and ulceration. It appears that most of the sequelae of the postthrombotic syndrome can be attributed to the loss of valvular function. (Arch Surg 1985;120:424-426) References 1. Strandness DE Jr, Langlois YE, Cramer MM, et al: Long-term sequelae of acute venous thrombosis . JAMA 1983;250:1289-1292.Crossref 2. Abramowitz HB, Queral LA, Flinn WR, et al: The use of photoplethysmography in the assessment of venous insufficiency: A comparison to venous pressure measurements . Surgery 1979;86:434-440. 3. Flinn WR, O'Mara CS, Peterson LK, et al: The use of photoplethysmography in the assessment of chronic venous insufficiency , in Kempczinski RF, Yao JST (eds): Practical Noninvasive Vascular Diagnosis . Chicago, Year Book Medical Publishers, 1982, chap 19. 4. Sumner DS: Doppler evaluation of the venous circulation , in Rutherford RB (ed): Vascular Surgery . Philadelphia, WB Saunders Co, 1977, chap 17. 5. Strandness DE Jr, Thiele BL: Venous evaluation , in Strandness DE Jr, Thiele BL (eds): Selected Topics in Venous Disorders . Mount Kisco, NY, Futura Publishing Co Inc, 1981, chap 2. 6. Gorsuch MS, Kempczinski R: Role of photoplethysmography in the evaluation of venous insufficiency . Bruit 1981;5:23-26. 7. Kingston V, Moore DJ, Shanik DG: Has photoplethysmography a role to play in the assessment of treated venous disease? Bruit 1982;6:10-13. 8. Cramer M, Langlois Y, Beach K, et al: Standardization of venous flow measurement by strain gauge plethysmography: The definition of normality . Bruit 1983;7:33-39. 9. Knox R, Cramer M, Beach K, et al: Pitfalls of venous occlusion plethysmography . Angiology 1982;33:268-276.Crossref 10. Tripolitis AJ, Blackshear WM, Bodily KC, et al: The influence of limb elevation, examination technique and outflow system design on venous plethysmography . Angiology 1980;31:154-163.Crossref 11. Hjelmstedt A: Pressure decrease in the dorsal veins on walking in persons with and without thrombosis . Acta Chir Scand 1968;134:531-539. 12. Browse NL, Burnand KG: The cause of venous ulceration . Lancet 1982;2:243-245.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

An Objective Assessment of the Physiologic Changes in the Postthrombotic Syndrome

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References (12)

Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1985.01390280018003
Publisher site
See Article on Publisher Site

Abstract

Abstract • To determine what physiologic changes might contribute to the development of the postthrombotic syndrome, venous outflow, venous refilling time, and valvular competence were assessed in 32 patients (39 limbs) with documented deep venous thrombosis. The follow-up ranged from nine to 144 months (mean, 41 months) after the acute deep venous thrombosis. Pain was noted by 49% of the patients, but more objective end points occurred less frequently (edema, 21%; pigmentation, 26%; ulceration, 3%). Venous outflow was lower in the affected limbs but was not a good indicator of those patients with or without symptoms. Venous refilling time after calf compression was markedly reduced in limbs with incompetent valves (mean ± SD, 8.4 ± 3.8 s v 25.3 ±12.1 s), as well as in those with edema, pigmentation, and ulceration. It appears that most of the sequelae of the postthrombotic syndrome can be attributed to the loss of valvular function. (Arch Surg 1985;120:424-426) References 1. Strandness DE Jr, Langlois YE, Cramer MM, et al: Long-term sequelae of acute venous thrombosis . JAMA 1983;250:1289-1292.Crossref 2. Abramowitz HB, Queral LA, Flinn WR, et al: The use of photoplethysmography in the assessment of venous insufficiency: A comparison to venous pressure measurements . Surgery 1979;86:434-440. 3. Flinn WR, O'Mara CS, Peterson LK, et al: The use of photoplethysmography in the assessment of chronic venous insufficiency , in Kempczinski RF, Yao JST (eds): Practical Noninvasive Vascular Diagnosis . Chicago, Year Book Medical Publishers, 1982, chap 19. 4. Sumner DS: Doppler evaluation of the venous circulation , in Rutherford RB (ed): Vascular Surgery . Philadelphia, WB Saunders Co, 1977, chap 17. 5. Strandness DE Jr, Thiele BL: Venous evaluation , in Strandness DE Jr, Thiele BL (eds): Selected Topics in Venous Disorders . Mount Kisco, NY, Futura Publishing Co Inc, 1981, chap 2. 6. Gorsuch MS, Kempczinski R: Role of photoplethysmography in the evaluation of venous insufficiency . Bruit 1981;5:23-26. 7. Kingston V, Moore DJ, Shanik DG: Has photoplethysmography a role to play in the assessment of treated venous disease? Bruit 1982;6:10-13. 8. Cramer M, Langlois Y, Beach K, et al: Standardization of venous flow measurement by strain gauge plethysmography: The definition of normality . Bruit 1983;7:33-39. 9. Knox R, Cramer M, Beach K, et al: Pitfalls of venous occlusion plethysmography . Angiology 1982;33:268-276.Crossref 10. Tripolitis AJ, Blackshear WM, Bodily KC, et al: The influence of limb elevation, examination technique and outflow system design on venous plethysmography . Angiology 1980;31:154-163.Crossref 11. Hjelmstedt A: Pressure decrease in the dorsal veins on walking in persons with and without thrombosis . Acta Chir Scand 1968;134:531-539. 12. Browse NL, Burnand KG: The cause of venous ulceration . Lancet 1982;2:243-245.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1985

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