[New advances in the knowledge on post-thrombotic syndrome].
The real incidence of the post-thrombotic syndrome (PTS) is not known precisely, though of the most part of the variable studies, seems be deduced that it can be established a year after the deep venous thrombosis (DVT) acute of the inferior members in 17% to the 50% of the patients. Inseparably united to the venous hypertension that continues to the development of the incompetence valvular, is accompanied of a series of inflammatory reactions that include the increase in the permeability endothelial, the union of the circulating leukocytes at endothelium, the infiltration by monocytes, lymphocytes and mastocytes of the connective tissue, and the development of infiltrated tissular fibrotics and different molecular markers. To the contrary that in the DVT, we know very little about the factors that increase the risk of suffering a PTS, since the only one identified up until now it is the recurrent DVT. Currently we have different scales standardized for their your clinical diagnosis, though the Echo-Doppler is, currently, the technique not invasive of election to detect, locate and evaluate the venous disability valvular and the venous obstruction chronicle. The modern technical of image: computed tomography (CT), magnetic resonance (MR) and isotopics have a promising future, even though are found in validation phase. The phlebothropics drugs are the therapeutic election strategy for the patients with PTS in those which is not indicated the surgery or in those which this is a assisting of the medical treatment. Finally, the deep venous surgery must be reserved for all those patients that suffer from venous insufficiency serious chronicle, with meaningful venous reflux and ambulatory venous hypertension.
Botella
F Gabriel
FG
Servicio de Medicina Interna, Hospital Clínico Universitario de Valencia.
Labiós Gómez
M
M
Portolés Reparaz
O
O
Cabanes Vila
J
J
D004730:Endothelium, Vascular / Q000166:cytology; D006801:Humans; D013577:Syndrome; D014652:Vascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D020246:Venous Thrombosis / Q000150:complications*