Inflammation in deep vein thrombosis and the development of post-thrombotic syndrome: a prospective study

Roumen-Klappe, Edith M.; Janssen, Mirian C. H.; Rossum, Joris van; Holewijn, Suzanne; Bokhoven, Marieke; Kaasjager, Karin A H; Wollersheim, Hub; Heijer, Martin den

doi:10.1111/j.1538-7836.2009.03286.x

Cited by 127 publications

(107 citation statements)

References 30 publications

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“…Other models focus on vein wall damage and acute and chronic inflammation as potential drivers of PTS. 18,35 Sustained venous hypertension can cause structural and biochemical abnormalities of the vein wall, resulting in pathological effects in the skin and subcutaneous tissues such as edema, hyperpigmentation, varicose veins, and ulceration. 24 Several studies have reported associations between elevated levels of various inflammation markers and PTS development 35,36 (see Role of Biomarkers to Predict PTS).…”

Section: Clinical Manifestations and Pathophysiology Characteristic Smentioning

confidence: 99%

The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

Kahn¹,

Comerota²,

Cushman³

et al. 2014

Circulation

486

410

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Section: Clinical Manifestations and Pathophysiology Characteristic Smentioning

confidence: 99%

The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

Kahn¹,

Comerota²,

Cushman³

et al. 2014

Circulation

486

410

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“…With regard to biomarkers that could help to predict PTS, recent studies have reported that elevated levels of markers of inflammation (eg, ICAM-1, interleukin-6, and C-reactive protein) 49,50 and D-dimer 40,51 early after diagnosis or within a few months of DVT were associated with the development of PTS. A large, prospective multicenter study that is examining the predictive role of various markers of inflammation, D-dimer, and thrombophilia in the development of PTS is currently under way.…”

Section: Individual Risk Factors For Ptsmentioning

confidence: 99%

How I treat postthrombotic syndrome

Kahn

2009

Blood

144

112

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Postthrombotic syndrome (PTS) is a chronic complication of deep venous thrombosis (DVT) that reduces quality of life and has important socioeconomic consequences. More than one-third of patients with DVT will develop PTS, and 5% to 10% of patients will develop severe PTS, which may manifest as venous ulceration. The principal risk factors for PTS are persistent leg symptoms 1 month after the acute episode of DVT, extensive DVT, recurrent ipsilateral DVT, obesity, and older age. Daily use of elastic compression stockings (ECSs) for 2 years after proximal DVT appears to reduce the risk of PTS; however, there is uncertainty about optimal duration of use and compression strength of ECSs and the magnitude of their effect. The cornerstone of managing PTS is compression therapy, primarily using ECSs. IntroductionDeep vein thrombosis (DVT) is a common vascular condition that is associated with significant rates of morbidity and mortality. Although pulmonary embolism and recurrent venous thrombosis are well-known consequences of DVT, an important, underappreciated, chronic consequence of DVT is postthrombotic syndrome (PTS). PTS develops in 20% to 50% of patients with DVT, 1,2 even when appropriate anticoagulant therapy is prescribed to treat the DVT. On the basis of its high incidence and prevalence, PTS is the single most frequent complication of DVT.Some practitioners may believe that PTS is primarily a cosmetic or "nuisance" problem. To the contrary, PTS is burdensome and potentially debilitating to patients, and it is a condition for which patients frequently seek medical advice. Manifestations of PTS vary from mild clinical symptoms or signs to more severe manifestations such as chronic leg pain that limits activity and ability to work, intractable edema, and leg ulcers. 3 PTS has been shown to have significant, adverse effects on quality of life and productivity, [4][5][6] and is costly as measured by health resource utilization, direct costs, and indirect costs. [7][8][9] In this review, I address the following questions: (1) How is PTS diagnosed? (2) Can we identify patients with DVT who are at risk of developing PTS? (3) How can PTS be prevented? (4) How do I treat PTS? and (5) What are the gaps in our understanding of PTS that should be addressed by future research? I also address upper-extremity PTS and the responsibility to discuss long-term prognosis with patients with DVT. This paper focuses on PTS in adults. Readers with an interest in PTS in children are referred to a recent review of this topic. 10 How I diagnose PTS Clinical presentation of PTSPTS is termed a "syndrome" because it is associated with groupings of symptoms and clinical signs that typically vary from patient to patient (Table 1). Patients with PTS experience aching pain, heaviness, swelling, cramps, itching, or tingling in the affected limb. Symptoms may be present in various combinations and may be persistent or intermittent. Typically, symptoms are aggravated by standing or walking and improve with resting, leg elevation, and lying dow...

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“…Roumen-Klappe et al in their 2009 work demonstrated that elevated IL-6, C-reactive protein (CRP), and intercellular adhesion molecule 1 (ICAM-1) levels after DVT development are directly related to PTS [21]. The increase in ICAM-1 level is also directly proportional to the severity of PTS.…”

Section: Deep Vein Thrombosismentioning

confidence: 95%

Vascular Manifestations of Behçet’s Disease

Demïrtürk¹,

Tünel²,

Alemdaroğlu³

2017

Behcet's Disease

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Behçet's disease (BD), a very morphologically diverse systemic disease, may involve the vascular system. The venous system is the most frequently attacked vessel system.The arterial system, when involved, increases the severity and morbidity of Behçet's disease. Cardiac involvement, although rare, can be very subtle and in itself increases the mortality. Vasculitis is the hallmark pathology resulting in occlusion, aneurysms, or both.Vascular involvement may be very challenging in all phases of treatment beginning from diagnosis till recovery and remission.

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Inflammation in deep vein thrombosis and the development of post-thrombotic syndrome: a prospective study

Cited by 127 publications

References 30 publications

The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

How I treat postthrombotic syndrome

Vascular Manifestations of Behçet’s Disease

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