Quality of life and economic costs associated with postthrombotic syndrome

Kachroo, Sumesh; Boyd, Dylan; Bookhart, Brahim; LaMori, Joyce; Schein, Jeff; Rosenberg, David; Reynolds, Matthew W.

doi:10.2146/ajhp110241

Cited by 51 publications

(42 citation statements)

References 29 publications

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“…Despite treatment, ≈10% to 20% of patients with DVT develop severe post-thrombotic syndrome, a chronic disorder that decreases quality of life and reduces the capacity to walk and to work. 80,81 In the most severe cases, patients with post-thrombotic syndrome can develop venous ulcers, which are slow to heal and costly for the healthcare system. 80,81 Heit et al 82 reported an incidence of venous ulcers of 1.8 per 1000 population per year.…”

Section: 24mentioning

confidence: 99%

“…80,81 In the most severe cases, patients with post-thrombotic syndrome can develop venous ulcers, which are slow to heal and costly for the healthcare system. 80,81 Heit et al 82 reported an incidence of venous ulcers of 1.8 per 1000 population per year. PE is associated with chronic thromboembolic pulmonary hypertension in approximately 4% of patients.…”

Section: 24mentioning

confidence: 99%

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Thrombosis

Raskob

Angchaisuksiri

Blanco

et al. 2014

ATVB

726

109

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Background— Thrombosis is the common pathology underlying ischemic heart disease, ischemic stroke, and venous thromboembolism (VTE). The Global Burden of Disease Study 2010 (GBD 2010) documented that ischemic heart disease and stroke collectively caused 1 in 4 deaths worldwide. GBD 2010 did not report data for VTE as a cause of death and disability. Objective— To review the literature on the global burden of disease caused by VTE. Approach and Results— We performed a systematic review of the literature on the global disease burden because of VTE in low-, middle-, and high-income countries. Studies from Western Europe, North America, Australia, and Southern Latin America (Argentina) yielded consistent results with annual incidences ranging from 0.75 to 2.69 per 1000 individuals in the population. The incidence increased to between 2 and 7 per 1000 among those aged ≥70 years. Although the incidence is lower in individuals of Chinese and Korean ethnicity, their disease burden is not low because of population aging. VTE associated with hospitalization was the leading cause of disability-adjusted life-years lost in low- and middle-income countries, and second in high-income countries, responsible for more disability-adjusted life-years lost than nosocomial pneumonia, catheter-related blood stream infections, and adverse drug events. Conclusions— VTE causes a major burden of disease across low-, middle-, and high-income countries. More detailed data on the global burden of VTE should be obtained to inform policy and resource allocation in health systems and to evaluate whether improved use of preventive measures will reduce the burden.

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Section: 24mentioning

confidence: 99%

Section: 24mentioning

confidence: 99%

Thrombosis

Raskob

Angchaisuksiri

Blanco

et al. 2014

ATVB

726

109

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“…Considering the fact that 30-50% of DVT patients will later develop PTS [4], one can approximate the incidence of PTS. In about 10-20% of the patients, a severe PTS develops, which manifests with permanent limb oedema, trophic changes of the skin and leg ulcers [5,6]. Post-thrombotic venous ulcers are usually hard to heal and their recurrence rate is extremely high (24-69% after 12 months) [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Endovenous laser ablation of incompetent calf perforating veins does not prevent recurrence of venous ulcers in patients with post-thrombotic syndrome

Золотухин¹,

Селиверстов²,

Khabazova³

et al. 2015

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Aim of the study was to assess efficacy of endovenous laser ablation of incompetent calf perforators in patients with post-thrombotic syndrome in preventing recurrence of venous leg ulcers. Material and methods:We conducted a single-centre prospective randomized study. Patients with healed venous ulcers were randomly assigned either to endovenous laser ablation of incompetent calf perforators together with compression therapy (n = 31), or to compression alone (n = 32). We used a 940 nm laser system and under sonographic control ablated all incompetent perforators in the area of healed ulcers. The primary endpoint of the study was the rate of ulcer recurrence within one year of follow-up. The technical success of laser ablation was assessed by duplex ultrasound 3-5 days and 1 year after the procedure. Results: Puncture and laser ablation of all perforators intended to treat was successful, irrespective of their location and diameter. There were no intraoperative and postoperative complications. The occlusion rate of perforators after 3-5 days was 76.9%. After one year only 17 perforators (18.7%) were still occluded. Venous ulcers recurred in 10 patients (32%) managed with laser ablation and in 11 patients (34%) using compression alone (p = 0.859). After one year in both groups of patients, the mean Venous Clinical Severity Score did not change. Conclusions: Endovenous laser ablation of incompetent perforating veins did not reduce the recurrence of venous ulcers in patients with post-thrombotic syndrome. The technical success of this procedure was low and the majority of incompetent perforating veins reopened within a year.

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“…Long-term complications of proximal DVT include Postthrombotic Syndrome (PTS), which is characterized by chronic limb heaviness, pain, swelling, paraesthesia, pruritis and pigmentation changes [1,2]. PTS affects between 23-43% of patients and has been shown to have a significant negative impact on quality of life and a large economic burden on the wider community [3][4][5][6][7]. Early active treatment to remove thrombus has been shown to result in better outcomes, including lower rates of venous valve dysfunction [8], recurrent DVT [9] and PTS [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Management of Ilio-Femoral Deep Vein Thrombosis: A Hybrid Approach

Bhamidipaty¹

2014

J Vasc Med Surg

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Despite recent innovations in clot lysis technology, management of acute ilio-femoral Deep Vein Thrombosis (DVT) remains a challenge worldwide. We revisit the work of a previous generation of vascular surgeons who created a temporary Arteriovenous Fistula (AVF) in combination with a surgical thrombectomy, to maximize blood flow through the newly revascularized vessel. Since this time, surgical thrombectomy along with the use of a temporary AVF, has been superseded by endovascular techniques: namely Catheter-Directed Thrombolysis (CDT) and Pharmacomechanical Thrombolysis (PMCT). We review the evolution of the management of ilio-femoral deep vein thrombosis, specifically examining the trials which investigate temporary AVF with surgical thrombectomy. Furthermore, we describe the surgical technique of creating a temporary AVF, including how to avoid venous hypertension and how to facilitate closure if required. Finally, in the age of hybrid techniques, we propose that a temporary AVF could be used in combination with current thrombus removal techniques to possibly lower the risk of recurrent thrombosis and complications such as post-thrombotic syndrome.

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Quality of life and economic costs associated with postthrombotic syndrome

Cited by 51 publications

References 29 publications

Thrombosis

Thrombosis

Endovenous laser ablation of incompetent calf perforating veins does not prevent recurrence of venous ulcers in patients with post-thrombotic syndrome

Management of Ilio-Femoral Deep Vein Thrombosis: A Hybrid Approach

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