Clinical-Instrumental Relationships in Post-Phlebitic Syndrome

Bartolo, M; Antignani, Pier Luigi; Nicosia, P.M.; Raffi, S

doi:10.1177/000331978503600109

Cited by 3 publications

(1 citation statement)

References 1 publication

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“…23,[41][42][43][44][45]56 Color-Doppler ultrasound is even more promising, as it enables the demonstration of typical flow irregularities inside recanalized veins. 35,[57][58][59] Either invasive or noninvasive methods can be employed to document and quantify the presence of obstruction, reflux, or both. 13,17,23,40,42,[44][45][46]60 Duplex ultrasound, performed with the patient standing, is the preferred noninvasive method for quantifying venous reflux.…”

Section: Diagnosismentioning

confidence: 99%

Postthrombotic Syndrome: Incidence, Prevention, and Management

Bernardi¹,

Bagatella²,

Frulla³

et al. 2001

Seminars in Vascular Medicine

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Mild to severe postthrombotic sequelae, including chronic pain, edema, and ulceration, arise in one third of patients short after deep vein thrombosis (DVT). Recurrent DVT is closely associated with the development of postthrombotic syndrome (PTS), whereas if the extent and location of DVT might be relevant remains unclear. Chronic venous hypertension and abnormal microvessel or lymphatic function also correlates with PTS. The diagnosis of PTS is based on clinical grounds only if patients report a history of documented DVT; otherwise, objective testing is required. To abate the prevalence of PTS, the best policy is represented by prevention of recurrent thrombosis and use of stockings. Despite a plenty of surgical options, conservative treatment is preferable because half of the patients improve or remain stable during follow-up, provided they wear elastic stockings. Clinical presentation has a prognostic value, as patients with initially severe symptoms enjoy a more favorable outcome than those who progressively deteriorate over time.

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Section: Diagnosismentioning

confidence: 99%

Postthrombotic Syndrome: Incidence, Prevention, and Management

Bernardi¹,

Bagatella²,

Frulla³

et al. 2001

Seminars in Vascular Medicine

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The post-thrombotic syndrome

Bernardi

Prandoni

2000

Current Opinion in Pulmonary Medicine

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One of every three patients with deep-vein thrombosis of the lower extremities will develop, within 5 years, post-thrombotic sequelae that vary from minor signs to severe manifestations such as chronic pain, intractable edema, and leg ulceration. The post-thrombotic syndrome (PTS) develops as a result of the combination of venous hypertension due to persistent outflow obstruction or valvular incompetence and abnormal microvasculature or lymphatic function. Among factors potentially related to the development of PTS, recurrent ipsilateral thrombosis plays a major role. Whether the extent and the location of the initial thrombosis are associated with the development of PTS is still controversial. The diagnosis of PTS can be accepted on clinical grounds for patients with a history of venous thrombosis. The combination of a standardized clinical evaluation with the results of compression ultrasonography and Doppler ultrasonography helps diagnose or exclude a previous proximal-vein thrombosis. Prevention of recurrent thrombosis and use of compression elastic stockings are the cornerstones of PTS prevention. The management of this condition is demanding and often frustrating. Although several surgical procedures have been tested, conservative treatment is largely preferable, as more than 50% of patients either remain stable or improve during long-term follow-up, if carefully supervised and instructed to wear proper elastic stockings. Clinical presentation helps predict the prognosis, being the outcome of patients who refer with initially severe manifestations more favorable than that of patients whose symptoms progressively deteriorate over time.

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The measurement of venous pressure by Doppler: is it a hemodynamic evaluation ?

Antignani¹,

Peruzzi²,

Spina³

2020

JTAVR

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Since 1980 using the Doppler method, planned by Bartolo, we have studied several patients by means of the measurement of venous pressures, both in orthostatism and in clinostatism. In a normal subject, in orthostatism the value of average pressure is 60 mmHg in the posterior tibial vein, and 60 mmHg in the long saphenous vein. When there are varicose veins, the average pressure is 90 and 96 mmHg respectively in the deep veins and in the superficial ones. In the case of post-thrombotic syndrome, the average values are 101 and 102 mmHg in the deep and superficial veins, respectively. In clinostatism, the normal values are under 20 mmHg and in subjects with vein thrombosis the value increase to 30 mmHg and more. After more than 30 years we discuss the reliability of the method, the hemodynamic basis and its clinical application in phlebological practice.

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Clinical-Instrumental Relationships in Post-Phlebitic Syndrome

Cited by 3 publications

References 1 publication

Postthrombotic Syndrome: Incidence, Prevention, and Management

Postthrombotic Syndrome: Incidence, Prevention, and Management

The post-thrombotic syndrome

The measurement of venous pressure by Doppler: is it a hemodynamic evaluation ?

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