Open surgical treatment for postthrombotic syndrome

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 48-55 ◽  
Author(s):  
Christian-Alexander Behrendt ◽  
Franziska Heidemann ◽  
Henrik Christian Rieß ◽  
Edgar Kleinspehn ◽  
Tobias Kühme ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Surgical Techniques ◽  
Venous Drainage ◽  
Compression Therapy ◽  
Postthrombotic Syndrome ◽  
Vein Thrombosis ◽  
Venous Valves ◽  
Small Subgroup ◽  
Open Surgical Treatment ◽  
Deep Vein

The postthrombotic syndrome counts as a frequent long-term complication after deep vein thrombosis with approximately 20%–50% of affected patients after deep vein thrombosis. The earliest that diagnosis of postthrombotic syndrome can be made is 6 months after deep vein thrombosis. Most patients suffer from swelling and chronic pain. In all, 5%–10% of patients may even develop venous ulcers. The complex etiology consists of limited venous drainage because of chronic occlusions and secondary insufficiencies of venous valves inducing non-physiological venous reflux. Conservative management, first of all compression therapy, is of crucial importance in treatment of postthrombotic syndrome. Endovascular and open surgical techniques can additionally be used in a small subgroup of patients. Although rarely performed, this article illuminates the open surgical techniques in treatment of postthrombotic syndrome such as venous bypass surgery, valve repair and varicose vein surgery.

scholarly journals Reduced incidence of vein occlusion and postthrombotic syndrome after immediate compression for deep vein thrombosis

Blood ◽  
2018 ◽  
Vol 132 (21) ◽  
pp. 2298-2304 ◽  
Author(s):  
Elham E. Amin ◽  
Ingrid M. Bistervels ◽  
Karina Meijer ◽  
Lidwine W. Tick ◽  
Saskia Middeldorp ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Compression Therapy ◽  
Postthrombotic Syndrome ◽  
Vein Thrombosis ◽  
Vein Occlusion ◽  
Absolute Reduction ◽  
Key Points ◽  
Deep Vein

Key Points Immediate compression therapy after DVT is associated with a 20% absolute reduction of RVO. The reduction of residual thrombosis is associated with an 8% absolute reduction of postthrombotic syndrome at 24 months.

Deep venous thrombosis and postthrombotic syndrome: Invasive management

2015 ◽  
Vol 30 (1_suppl) ◽  
pp. 59-66 ◽  
Author(s):  
AJ Comerota
Keyword(s):  
Deep Vein Thrombosis ◽  
Vena Cava ◽  
Venous Drainage ◽  
Percutaneous Treatment ◽  
Postthrombotic Syndrome ◽  
Venous Outflow ◽  
Vein Thrombosis ◽  
Valvular Function ◽  
Deep Vein ◽  
Invasive Management

Invasive management of postthrombotic syndrome encompasses the two ends of the deep vein thrombosis spectrum, patients with acute iliofemoral deep vein thrombosis and those with chronic postthrombotic iliofemoral venous obstruction. Of all patients with acute deep vein thrombosis, those with involvement of the iliofemoral segments have the most severe chronic postthrombotic morbidity. Catheter-based techniques now permit percutaneous treatment to eliminate thrombus, restore patency, potentially maintain valvular function, and improve quality of life. Randomized trial data support an initial treatment strategy of thrombus removal. Failure to eliminate acute thrombus from the iliofemoral system leads to chronic postthrombotic obstruction of venous outflow. Debilitating chronic postthrombotic symptoms of the long-standing obstruction of venous outflow can be reduced by restoring unobstructed venous drainage from the profunda femoris vein to the vena cava.

scholarly journals Diagnosis and Treatment of Postthrombotic Syndrome

2020 ◽  
Vol 40 (02) ◽  
pp. 214-220
Author(s):  
Guido Bruning ◽  
Jasmin Woitalla-Bruning ◽  
Anne-Caroline Queisser ◽  
Johanna Katharina Buhr
Keyword(s):  
Varicose Veins ◽  
Compression Therapy ◽  
Postthrombotic Syndrome ◽  
Venous Reflux ◽  
Venous Valve ◽  
Vein Thrombosis ◽  
Venous Valves ◽  
Fast Progression ◽  
Secondary Healing ◽  
Deep Vein

AbstractAfter acute treatment of deep vein thrombosis, not only the risk but also associated side effects of postthrombotic syndrome (PTS) are often underestimated.There are essentially two main types of PTS.1. Obstructive type—no sufficient recanalization of the deep vein.2. Refluctive type—sufficient recanalization of the deep vein, but insufficient venous valves in conjunction with venous reflux.A statement regarding deep vein recanalization and venous valve function can be made at the earliest after 6 months.PTS is often diagnosed without appropriate medical history. However, the assessment of the degree of recanalization and venous reflux is paramount to the medical prognosis. In our opinion, beside proximal thrombosis, sufficient recanalization combined with a strong venous reflux, especially in the popliteal vein, works as a powerful predictor for an unfavorable and fast progression of PTS and chronic venous insufficiency. Thus, the obstructive type is prognostically more favorable. For PTS in general, consistent compression therapy represents the first-line treatment option.With concomitant varicosis, one should assess whether the varicose veins represent primary varicosis with reflux or secondary varicosis without reflux. Especially in the presence of venous ulcers, the elimination of concomitant primary varicosis leads to an improved prognosis. Moist wound treatment is considered to be the standard treatment for all wounds undergoing secondary healing. A standardized set of topical therapeutic agents also facilitates the treatment. In individual cases “ulcershaving” and mesh graft transplantation proved to be successful.

scholarly journals Postthrombotic Syndrome in Acute Iliofemoral Deep Vein Thrombosis

2020 ◽  
Author(s):  
Permesh Singh Dhillon ◽  
Asim Shah ◽  
Thomas Hall ◽  
Said Habib
Keyword(s):  
Deep Vein Thrombosis ◽  
Postthrombotic Syndrome ◽  
Vein Thrombosis ◽  
Deep Vein

scholarly journals Postthrombotic Syndrome: Surgical Possibilities

Thrombosis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ajay K. Khanna ◽  
Shivanshu Singh
Keyword(s):  
Promising Result ◽  
Postthrombotic Syndrome ◽  
Axillary Vein ◽  
Foam Sclerotherapy ◽  
Venous Flow ◽  
Vein Thrombosis ◽  
Venous Valves ◽  
Endovascular Interventions ◽  
Deep Vein

Postthrombotic syndrome (PTS) is a late outcome of deep vein thrombosis characterized by cramping pain, swelling, hyperpigmentation, eczema, lipodermatosclerosis, and ulceration in the leg due to increased venous outflow resistance and reflux venous flow. Newer surgical and endovascular interventions have a promising result in the management of postthrombotic syndrome. Early surgical or endovascular interventions in appropriately selected patients may decrease the incidence of recurrent ulceration and skin changes and provide a better quality of life. Duplex and IVUS (intravenous ultrasound) along with venography serve as cornerstone investigative tools for assessment of reflux and obstruction. Venous obstruction, if present, should be addressed earlier than reflux. It requires endovenous stenting, endophlebectomy, or open bypass procedures. Venous stripping, foam sclerotherapy, radiofrequency, or laser ablation are used to abolish superficial venous reflux. Valvuloplasty procedures are useful for incompetent but intact deep venous valves, while transposition or axillary vein autotransplantation is done for completely destroyed valves.

scholarly journals Long‐term risk of postthrombotic syndrome after symptomatic distal deep vein thrombosis: The CACTUS‐PTS study

2020 ◽  
Vol 18 (4) ◽  
pp. 857-864 ◽  
Author(s):  
Jean‐Philippe Galanaud ◽  
Marc Righini ◽  
Lorris Le Collen ◽  
Aymeric Douillard ◽  
Helia Robert‐Ebadi ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Postthrombotic Syndrome ◽  
Vein Thrombosis ◽  
Distal Deep Vein Thrombosis ◽  
Deep Vein
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