Venous claudication in iliofemoral thrombosis: Long-term effects on venous hemodynamics, clinical status, and quality of life

Delis, Konstantinos T.; Bountouroglou, B; Mansfield, Averil O.

doi:10.1016/j.jvs.2004.02.017

Cited by 149 publications

(246 citation statements)

References 43 publications

(80 reference statements)

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“…Furthermore, up to 90% of patients with symptomatic, iliofemoral DVT develop significant symptoms of the post-thrombotic syndrome despite receiving anticoagulation therapy (8,9). Patients with iliofemoral DVT treated with anticoagulation alone have a poor quality of life, with 5% to 15% developing venous ulcers within five years (7,10,11). These observations have led clinicians to adopt a treatment strategy involving early thrombus removal, especially for patients with iliofemoral DVT, to improve long-term quality of life.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis using manual aspiration thrombectomy: long-term result of 139 patients from a single center

Oğuzkurt¹,

Özkan²,

Gülcan³

et al. 2011

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 99%

Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis using manual aspiration thrombectomy: long-term result of 139 patients from a single center

Oğuzkurt¹,

Özkan²,

Gülcan³

et al. 2011

Diagn Interv Radiol

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“…Indeed, most patients with iliofemoral DVT treated with anticoagulation alone develop chronic venous insufficiency, and many develop venous claudication and stasis ulcers. [10][11][12][13] These data prompted us to consider treatments in addition to anticoagulation alone for our patient. In patients with iliofemoral DVT, treatments that remove the thrombus and maintain venous patency resolve symptoms such as edema and prevent chronic venous insufficiency syndromes.…”

Section: Ovarian Cancer D Abdominal Aortic Aneurysm E May-thurner Smentioning

confidence: 97%

57-Year-Old Woman With Acute Lower Extremity Pain and Swelling

Coss

Mueller

2009

Mayo Clinic Proceedings

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A 57-year-old postmenopausal woman presented to our emergency department with a 1-day history of left leg pain, redness, and swelling. She reported no chest pain or shortness of breath. During the previous week, she made several car trips, each lasting 3 hours. Her medical history was remarkable for a left femoral and popliteal deep venous thrombosis (DVT) after breast reduction surgery during the previous year, which was treated with 1 week of subcutaneous low-molecular-weight heparin therapy and 6 months of oral warfarin therapy. She also had a history of hyperlipidemia, allergies, gastroesophageal reflux, and depression. She denied using tobacco or illicit drugs. Breast, cervical, and colon cancer screening were current and unremarkable. Daily oral medications were atorvastatin, sertraline, montelukast, and pantoprazole. She reported no family history of DVT.On arrival at the emergency department, the patient's vital signs were as follows: temperature, 36.8°C; blood pressure, 150/77 mm Hg; heart rate, 71 beats/min; respiratory rate, 18 breaths/min; and room air oxygen saturation, 93%. Physical examination revealed erythema, warmth, tenderness, and swelling of the entire left leg with intact distal pulses ( Figure 1). The right leg was unaffected. Laboratory tests revealed the following: white blood cell count, 9.3 × 10 9 /L; hemoglobin, 14.7 g/dL; platelets, 321 × 10 9 /L; creatinine, 0.7 mg/dL; activated partial thromboplastin time, 23 seconds; and international normalized ratio, 0.9. Which one of the following is the most likely diagnosis in our patient? a. Deep venous thrombosis b. Muscle strain c. Superficial thrombophlebitis d. Ruptured Baker cyst e. CellulitisDeep venous thrombosis is the most likely diagnosis given the prior DVT, recent car trips, and clinical findings. One can assess the probability of DVT by using the Modified Wells Clinical Score.1 One point each is given for clinical features, such as active cancer, paralysis or recent lower extremity immobilization, being bedridden for more than 3 days within the previous 4 weeks, localized tenderness along the deep venous system, whole leg swelling, calf swelling by more than 3 cm compared with the asymptomatic leg, pitting edema, collateral superficial veins, and previous DVT. Two points are subtracted when an alternative diagnosis is more likely than DVT. A score of 2 or more indicates that DVT is likely, whereas a score of 1 or less indicates that DVT is unlikely. Our patient's score was 2, indicating that DVT was likely.Muscle strain can mimic DVT; 40% of patients with suspected DVT but negative findings on contrast venography have muscle injury as the cause of lower extremity symptoms.2 Our patient, however, had not experienced a recent injury. Superficial thrombophlebitis (ie, acute inflammation of a superficial vein caused by a thrombosis) usually presents with a palpable cord, inconsistent with our patient's clinical findings. A ruptured Baker (popliteal) cyst can mimic DVT because it causes leg pain and swelling. However, a ruptured Bake...

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“…The natural history of IFDVT treated with anticoagulation alone is one of expected posthrombotic morbidity [1,2]. Over the short course of 5 years, persistent obstruction of the iliofemoral venous drainage was found in 70%, chronic venous insufficiency in over 90% of patients, venous claudication in 40% and venous ulceration in 15%.…”

Section: Iliofemoral Deep Vein Thrombosis (Ifdvt)mentioning

confidence: 99%

Catheter-directed thrombolysis for iliofemoral deep vein thrombosis: helpful or hurtful?

Comerota¹

2015

Expert Review of Hematology

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Venous claudication in iliofemoral thrombosis: Long-term effects on venous hemodynamics, clinical status, and quality of life

Cited by 149 publications

References 43 publications

Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis using manual aspiration thrombectomy: long-term result of 139 patients from a single center

Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis using manual aspiration thrombectomy: long-term result of 139 patients from a single center

57-Year-Old Woman With Acute Lower Extremity Pain and Swelling

Catheter-directed thrombolysis for iliofemoral deep vein thrombosis: helpful or hurtful?

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