Valvular reflux after deep vein thrombosis: Incidence and time of occurrence

Abstract

From December 1986 to December 1990, 268 patients with acute deep vein thrombosis were studied in our laboratory. From this group 107 patients (123 legs with deep vein thrombosis) were placed in our long-term follow-up program. The documentation of valvular reflux and its site was demonstrated by duplex scanning. The duplex studies were done at intervals of 1 and 7 days, 1 month, every 3 months for the first year, and then yearly thereafter. The mean follow-up time for these patients was 341 days. In addition, reflux was evaluated in 502 patients with negative duplex study results and no previous history of deep vein thrombosis or chronic venous insufficiency. In the patients with acute deep vein thrombosis, valvular incompetence was noted in 17 limbs (14%) at the time of the initial study. Reflux was absent in 106 limbs (86%). In this last group reflux developed in 17% of the limbs by day 7. By the end of the first month, 37% demonstrated reflux. By the end of the first year, more than two thirds of the involved limbs had developed valvular incompetence. The distribution of reflux at the end of the first year of follow-up was the following: (1) popliteal vein, 58%; (2) superficial femoral vein, 37%; (3) greater saphenous vein, 25%; and (4) posterior tibial vein, 18%. Reflux seems to be more frequent in the segments previously affected with deep vein thrombosis. Among cases where segments were initially affected with thrombi, after 1 year the incidence of reflux was 53%, 44%, 59%, and 33% for the common femoral vein, superficial femoral, popliteal vein, and posterior tibial vein, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

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

“…Reflux develops and progresses over time not only in venous segment distal to the thrombotic location but also in segments proximal to the site of thrombosis. This mechanism is yet poorly understood [17,[21][22][23]. A plausible explanation, described by Raju et al, is that perivenous and mural fibrosis may extend beyond the thrombosed segment to involve adjacent segments of preserving valve cusps, but inducing secondary reflux from valve station restriction [24].…”

Effectiveness of the Planned Teaching Program on Deep Vein Thrombosis among the Staff Nurses of selected hospital.

“…If not treated this is the cause of increased morbidity and disability. In a recent study by Markel et al (1992), 110 patients (126 legs) with DVT were prospectively followed using duplex during the cause of 5 consecutive years. …”

“…It is recommended that staff nurses using the Author DVT scale should evaluate for themselves the best cut-off score to achieve maximum predictive accuracy. Markel (1992), deep vein thrombosis is a disorder frequently affecting the DVT of the lower limbs, its onset is included by know risk factors. The main complications of DVT are pulmonary embolism and post thrombotic syndrome (PST).…”

Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines

“…Despite therapeutic anticoagulation and elastic compression stocking therapy, a significant proportion of DVT patients may develop postthrombotic sequelae. Because the iliac vein rarely recanalizes, patients with chronic iliofemoral DVT develop valvular reflux and have persistent venous obstruction, a combination that tends to be associated with the worst forms of PTS [31,208]. Although the severity of PTS can vary, the signs and symptoms can be life-style limiting and include pain, edema, telangiectasia, hyperpigmentation, and ulceration.…”