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An Objective Assessment of the Physiologic Changes in the Postthrombotic Syndrome
Lois A. Killewich, MD, PhD;
Robert Martin;
Miles Cramer;
Kirk W. Beach, MD, PhD;
D. E. Strandness, Jr, MD
Arch Surg. 1985;120(4):424-426.
Abstract
• To determine what physiologic changes might contribute to the development of the postthrombotic syndrome, venous outflow, venous refilling time, and valvular competence were assessed in 32 patients (39 limbs) with documented deep venous thrombosis. The follow-up ranged from nine to 144 months (mean, 41 months) after the acute deep venous thrombosis. Pain was noted by 49% of the patients, but more objective end points occurred less frequently (edema, 21%; pigmentation, 26%; ulceration, 3%). Venous outflow was lower in the affected limbs but was not a good indicator of those patients with or without symptoms. Venous refilling time after calf compression was markedly reduced in limbs with incompetent valves (mean ± SD, 8.4 ± 3.8 s v 25.3 ±12.1 s), as well as in those with edema, pigmentation, and ulceration. It appears that most of the sequelae of the postthrombotic syndrome can be attributed to the loss of valvular function.
(Arch Surg 1985;120:424-426)
Author Affiliations
From the Department of Surgery, University of Washington School of Medicine, Seattle.
Footnotes
Accepted for publication Sept 12, 1984.
Reprint requests to Department of Surgery, RF-25, University of Washington, Seattle, WA 98195 (Dr Strandness).
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