The Severity of Manifestations of the Post-Thrombotic Syndrome Following Different Variants of Conservative Treatment of Deep Vein Thrombosis in the Lower Extremities

Flebologiia ◽  
2018 ◽  
Vol 12 (3) ◽  
pp. 118
Author(s):  
I. N. Son'kin ◽  
D. V. Krylov ◽  
V. Yu. Mel'nik ◽  
A. I. Atabekov
2021 ◽  
Vol 156 (5) ◽  
pp. 251-252
Author(s):  
Francisco Galeano-Valle ◽  
Jorge del-Toro-Cervera ◽  
Pablo Demelo-Rodríguez

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Marit Engeseth ◽  
Tone Enden ◽  
Per Morten Sandset ◽  
Hilde Skuterud Wik

Abstract Background Post-thrombotic syndrome (PTS) is a frequent chronic complication of proximal deep vein thrombosis (DVT) of the lower limb, but predictors of PTS are not well established. We aimed to examine predictors of PTS in patients with long-term PTS following proximal DVT. Methods During 2006–09, 209 patients with a first time acute upper femoral or iliofemoral DVT were randomized to receive either additional catheter-directed thrombolysis or conventional therapy alone. In 2017, the 170 still-living participants were invited to participate in a cross-sectional follow-up study. In the absence of a gold standard diagnostic test, PTS was defined in line with clinical practice by four mandatory, predefined clinical criteria: 1. An objectively verified DVT; 2. Chronic complaints (> 1 month) in the DVT leg; 3. Complaints appeared after the DVT; and 4. An alternative diagnosis was unlikely. Possible predictors of PTS were identified with multivariate logistic regression. Results Eighty-eight patients (52%) were included 8–10 years following the index DVT, and 44 patients (50%) were diagnosed with PTS by the predefined clinical criteria. Younger age and higher baseline Villalta score were found to be independent predictors of PTS, i.e., OR 0.96 (95% CI, 0.93–0.99), and 1.23 (95% CI, 1.02–1.49), respectively. Lack of iliofemoral patency at six months follow-up was significant in the bivariate analysis, but did not prove to be significant after the multivariate adjustments. Conclusions In long-term follow up after high proximal DVT, younger age and higher Villalta score at DVT diagnosis were independent predictors of PTS.


2013 ◽  
Vol 160 (6) ◽  
pp. 817-824 ◽  
Author(s):  
Lara N. Roberts ◽  
Raj K. Patel ◽  
Paradzai B. Chitongo ◽  
Lynda Bonner ◽  
Roopen Arya

2021 ◽  
Vol 14 (3) ◽  
pp. 193-198
Author(s):  
Boris Sukovatykh ◽  
Aleksey Viktorovich Sereditsky ◽  
Andrey Mikhailovich Azarov ◽  
Vadim Feliksovich Muradyan ◽  
Mikhail Borisovich Sukovatykh ◽  
...  

The aim of the study was to improve the conservative treatment options for proximal deep vein thrombosis of low extremities associated with phlegmasia alba dolens optimization of anticoagulant therapy and paravascular injection of the anti-inflammatory medical mixture in areas of the most intense inflammatory process.Materials and methods. The results of treatment of two statistically homogeneous groups of patients with proximal deep vein thrombosis of the lower extremities associated with white phlegmasia were compared. In the first group (n = 30), standard conservative treatment was carried out using rivaroxaban as an anticoagulant; in the second group (n = 30), initial heparin therapy was first performed and, additionally, the following mixture was administered in the places of the greatest severity of inflammatory process under ultrasound control: dexamethasone 16 mg, heparin 5 thousand units, 0.25% novocaine solution 20.0 ml. During treatment the incidence of hemorrhagic syndrome was recorded. The results were assessed after one year according to the degree of deep vein lumen restoration and the severity of venous outflow impairment according to the Villalta scale. Results. In patients of both groups, every tenth patient developed some minor manifestations of hemorrhagic syndrome during treatment with rivaroxaban that was corrected by a decrease in the dose of anticoagulant.Complete restoration of the lumen of the veins occurred in 20.0%, patients of the first group and in 40.0%, patients of the second group; partial, in 63.3% and 56.7% of patients, respectively, minimal - in 16.7% and 3.3% of patients, respectively.In the first group, clinical disorders of venous outflow were absent in 20.0% of patients, a weak degree of severity was registered in 23.3%, an average - in 40.0%, and a strong one in 16.7% of patients, and in the second group, in 40 %, 26.7%, 30% and 3.3% of patients, respectively.Different minor hemorrhagic complications after Rivaroxaban intake occurred equally in both groups in each of ten patients. These complications were treated by the reduction of the anticoagulants dose.Complete restoration of the vein lumen occurred in the first group in 20.0%, and in the second group in 40.0% of patients, partial restoration, in 63.3% and 56.7% of patients, minimal - in 16.7% and 3.3% of patients respectively.In patients of the first group clinical venous congestion was absent in 20,0% of patients, mild congestion was manifested in 23,3% of patients, moderate - in 40,0% of patients, and severe was in 16,7% of cases. In the second group, the obtained data was 40%, 26,7%, 30%, and 3,3% of patients, respectively. Conclusion. Starting therapy with heparin and paravascular injection of anti-inflammatory mixture helps improve treatment outcomes.


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