title: Valvular dysfunction and venous obstruction in the post-thrombotic syndrome.
abstract: Medical thrombosis physicians have tended to view deep vein thrombosis (DVT) as essentially a problem of biology and hematology. This "field condition" concept holds that in susceptible individuals, DVT risk factors lead to a global hypercoagulable state which results in venous thrombosis. However, less attention has been paid to the key problems of venous anatomy and physiology that lead to the post-thrombotic syndrome (PTS) and its major health consequences. The primary objectives of this article are: (1) to review the macroscopic pathophysiology of PTS; (2) to discuss the roles of valvular reflux and venous obstruction in the development of PTS; and (3) to explore new endovascular PTS prevention and treatment strategies that feature the prevention or elimination of valvular reflux and late venous obstruction to improve DVT patient outcomes.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA. vedanthams@mir.wustl.edu
authors.forename: Suresh
authors.initials: S
authors.lastname: Vedantham
mesh_terms: D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use; D002404:Catheterization; D003131:Combined Modality Therapy; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D053685:Laser Therapy; D054070:Postthrombotic Syndrome / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control / Q000628:therapy; D012008:Recurrence; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D055422:Venous Valves / Q000473:pathology / Q000503:physiopathology*
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents