The occurrence of the post-thrombotic changes after an acute deep venous thrombosis. A prospective two-year follow-up study.
BACKGROUND
The aim of the study is to investigate the development of subjective and objective findings during the first two years after DVT (deep venous thrombosis).


METHODS
This prospective two-year follow-up study was established in Tampere University Hospital in Finland. Twenty-six patients with a two-year follow-up after a phlebographically confirmed DVT were followed. Patients were treated conventionally with heparin and warfarin. Phlebography was repeated 7 months after DVT. Color-flow duplex imaging (CFDI) was performed in both legs 7 and 20 months after DVT. The subjective symptoms in both legs were recorded at the beginning and at the end of the follow-up. The development of venous reflux, obstruction and subjective symptoms after DVT were studied.


RESULTS
50% of the legs with DVT had a pathological (deep reflux or obstructive change) CFDI-finding in the popliteal segment after a 20-month follow-up. The pathological findings in the control legs were rare. The rate of recanalisation was high. There was no difference between calf and more proximal DVTs. Pain (62%), oedema (46%) and pigmentation (35%) were common and only 27% of the legs with DVT were asymptomatic.


CONCLUSIONS
The development of the post-thrombotic syndrome begins quite early. The frequency of the subjective symptoms is high. Calf DVT may lead to postthrombotic sequelae in the popliteal segment.
Saarinen
J
J
Department of Surgery, Tampere University Hospital, Finland.
Kallio
T
T
Lehto
M
M
Hiltunen
S
S
Sisto
T
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001458:Bandages; D001783:Blood Flow Velocity; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011152:Popliteal Vein / Q000000981:diagnostic imaging; D011446:Prospective Studies; D015912:Thrombolytic Therapy; D018615:Ultrasonography, Doppler, Color; D014689:Venous Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D020246:Venous Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D005343:Fibrinolytic Agents