Deep Vein Thrombosis and Post Thrombotic Syndrome

Prepared by Peter Henke, MD
Corresponding chapter in Handbook of Venous Disorders: Chapters 13, 17 and 19

Delis KT, Bountouroglou D, Mansfield AO. Venous claudication in iliofemoral thrombosis: long-term effects on venous hemodynamics, clinical status, and quality of life. Ann Surg 2004;239:118-26.

PMID: 14685109
Comment: This carefully done study shows patients with iliofemoral obstruction fair poorly long term and sets the stage for aggressive thrombus removal.

Prandoni P, Lensing AW, Prins MH, Frulla M, Marchiori A, Bernardi E, Tormene D, Mosena L, Pagnan A, Girolami A. Below-knee elastic compression stockings to prevent the post-thrombotic syndrome: a randomized, controlled trial. Ann Intern Med 2004;141:249-56.

PMID: 15313740
Comment: This study showed the importance of early and consistent application of compression in preventing PTS.

Prandoni P, Prins MH, Lensing AW, Ghirarduzzi A,  Ageno W, Imberti D, Scannapieco G, Ambrosio GB, Pesavento R, Cuppini S, Quintavalla R, Agnelli G; AESOPUS Investigators. Residual thrombosis on ultrasonography to guide the duration of anticoagulation in patients with deep venous thrombosis: a randomized trial. Ann Intern Med 2009;150:577-85.

PMID: 19414836
Comment: Residual venous abnormality, probably vein scar or residual thrombus, confers an increased risk of recurrence and may help to judge anticoagulant duration.

Prandoni P, Lensing AW, Cogo A, Cuppini S, Villalta S, Carta M, Cattelan AM, Polistena P, Bernardi E, Prins MH. University Hospital of Padua, Italy. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med 1996;125:1-7.

PMID: 8644983
Comment: An excellent natural history study of post DVT vein wall injury and one of the first to define the incidence of PTS.

Kahn SR, Shrier I, Julian JA, Ducruet T, Arsenault L, Miron MJ, Roussin A, Desmarais S, Joyal F, Kassis J, Solymoss S, Desjardins L, Lamping DL, Johri M, Ginsberg JS. Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis. Ann Intern Med 2008;149:698-707.

PMID: 19017588
Comment: A recent careful study revealing independent factors associated with PTS.