Pathophysiology of Post-Thrombotic Syndrome: The Effect of Recurrent Venous Thrombosis and Inherited Thrombophilia

Kreidy, Raghid

doi:10.5402/2011/513503

Cited by 6 publications

(8 citation statements)

References 54 publications

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“…In some countries with high prevalence of prothrombotic genetic polymorphism, thrombophilia was reported to be the second most common cause of VTE [ 14 ]. Recent studies suggested that thrombophilia not only predisposes to the development of venous thrombosis but also seems to interfere in the development of postthrombotic syndrome either directly by prolonging residual venous thrombosis or indirectly by increasing venous thrombotic recurrence rate [ 27 , 28 ]. Assessment for genetic risk factors for VTE allows to avoid thrombogenic treatment (estroprogestative treatment) and to prevent venous thrombosis in high risk conditions (pregnancy, trauma, surgery, and long-haul air travel) [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Influence of Acquired and Genetic Risk Factors on the Prevention, Management, and Treatment of Thromboembolic Disease

Kreidy

2014

International Journal of Vascular Medicine

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Prevention, management, and treatment of venous thromboembolism requires understanding of the epidemiology and associated risk factors, particularly in recognizing populations warranting prophylaxis, in evaluating patients with high risk situations, and in determining the duration of anticoagulation required to minimize recurrent thrombosis and to avoid postthrombotic syndrome. The present paper reviews recent advances concerning acquired and genetic risk factors for venous thrombosis, analyses individual risks related to age, and focuses on thrombotic genetic risk factors and the synergistic gene-environment and gene-gene interactions and their importance in the management and treatment of venous thromboembolic disease.

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Section: Discussionmentioning

confidence: 99%

Influence of Acquired and Genetic Risk Factors on the Prevention, Management, and Treatment of Thromboembolic Disease

Kreidy

2014

International Journal of Vascular Medicine

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“…The subacute inflammatory reaction in thrombus resolution spreads to the vessel wall with leukocyte influx and vessel wall remodeling, ultimately leaving behind a thickened, fibrotic, and noncompliant vein wall with incompetent valvular function . Perivenous and mural fibrosis extend beyond thrombosed segments affecting adjacent segments of valve cusps, but inducing secondary reflux . The prevalence of venous reflux increases over time and plateaus after 1–2 years .…”

Section: Pathomechanisms Of Nonresolving Thrombi and Ptsmentioning

confidence: 99%

Chronic complications of venous thromboembolism

Winter

Schernthaner

Lang

2017

Journal of Thrombosis and Haemostasis

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Venous thromboembolism (VTE) is a common disease (~700 per 100 000) that is associated with significant risk of recurrence, chronic complications, and substantial mortality, with reported death rates of up to 40% at 10 years. The development of novel anticoagulants has revolutionized the treatment of acute VTE, while strategies for prevention and treatment of chronic complications still seek for such a landmark change. Impaired thrombus resolution is the common denominator behind VTE complications, which are postthrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (CTEPH). PTS and CTEPH are associated with substantial morbidity and high healthcare expenses. While PTS occurs in up to 50% of patients after symptomatic deep vein thrombosis, only a small and poorly defined number of patients are diagnosed with CTEPH after pulmonary embolism. This review is a comprehensive summary of VTE-related chronic complications, their epidemiology, diagnosis, and treatment.

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“…Chronic venous insufficiency, post-thrombotic syndrome (PTS) and pulmonary embolism (PE) are the main complications of DVT. 1 The traditional venous anatomy of the LLs has been described as a continuous flow of veins without duplication. 2 However, recent studies based on duplex ultrasonography, venography and cadavers have demonstrated variations in the anatomy of the venous system of the lower extremities.…”

Section: Introductionmentioning

confidence: 99%

“…Chronic venous insufficiency, post-thrombotic syndrome (PTS) and pulmonary embolism (PE) are the main complications of DVT. 1…”

Section: Introductionmentioning

confidence: 99%

Clinical implications of the anatomical variation of deep venous thrombosis

et al. 2017

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Introduction Little is known about the anatomic variation and its implication in patients with lower limb deep venous thrombosis (DVT). We studied the clinical presentation, site of thrombosis and risk factors based on the anatomic distribution of lower limb DVT. Methods A retrospective analysis of clinically suspected DVT cases was conducted between 2008 and 2012. DVT was categorized by the location of the thrombosed segment and limb involved. The DVT anatomic segments were assessed according to left-to-right ratio, predisposing factors and clinical presentations. Results A total of 637 patients with DVT were included with a mean age of 50 ± 17 years (51%; females). The most frequently thrombosed segments were popliteal, posterior tibial and profunda femoris veins. DVT was more common at the left side, with a left-to-right ratio of 1.5:1. Bilateral DVT cases (38.5%) had more prior history of DVT as compared to left- (20.3%) and right-sided DVTs (22.6%); p = 0.01. Bilateral DVT was complicated more with post-thrombotic syndrome (leg ulcer) ( p = 0.02). The rates of pulmonary embolism (25%) and mortality (23.1%) were significantly higher for bilateral DVT in comparison to left- and right-sided DVT. Abnormal coagulation profile was significantly associated with posterior tibial DVT (81% vs. 71.4%; p = 0.01) as compared to patients with normal coagulation profile. Conclusion Lower limb DVTs are more common at the left side; however, patients with bilateral DVT have higher frequency of recurrence, post-thrombotic syndrome, pulmonary embolism and mortality. The anatomic segments of DVT show specific distribution depending on the predisposing factors. These findings could improve our understanding of the pathophysiology and management of DVT patients.

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Pathophysiology of Post-Thrombotic Syndrome: The Effect of Recurrent Venous Thrombosis and Inherited Thrombophilia

Cited by 6 publications

References 54 publications

Influence of Acquired and Genetic Risk Factors on the Prevention, Management, and Treatment of Thromboembolic Disease

Influence of Acquired and Genetic Risk Factors on the Prevention, Management, and Treatment of Thromboembolic Disease

Chronic complications of venous thromboembolism

Clinical implications of the anatomical variation of deep venous thrombosis

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