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Patterns of venous insufficiency after an acute deep vein thrombosis.
J Am Coll Surg 2005; 201(2):231-8JA

Abstract

BACKGROUND

The purpose of this study was to investigate patterns of venous insufficiency during a 12-month period after an acute deep vein thrombosis.

STUDY DESIGN

Seventy limbs in 67 patients with an acute deep vein thrombosis (DVT) involving 147 anatomic segments were evaluated with duplex scanning at 1 month, 3 months, 6 months, and 1 year. Venous segments were examined whether they were occluded, partially recanalized, or totally recanalized, and the development of venous reflux was evaluated.

RESULTS

The segments investigated were the common femoral vein (38 segments), femoral vein (33 segments), popliteal vein (36 segments), and calf veins (40 segments). There were 35 limbs with isolated DVT and the remaining 35 had multisegment DVT. At 1 year, thrombi had fully resolved in 76% of the segments, 20% remained partially recanalized, and 5% were occluded. The venous occlusion was most predominant in the femoral vein (21%) at 1 year. On the contrary, rapid recanalization was obtained in calf veins than in proximal veins at each examination (p < 0.01). Deep vein insufficiency was detected as early as 1 month after development of DVT, and the reflux was most predominant in popliteal veins (56%), followed by femoral veins (18%). No reflux was found in calf veins. Multisegment DVTs had a significantly higher incidence of deep vein insufficiency than single segment DVTs at 1 year. Development of superficial venous insufficiency was found in 5 limbs (7%) and perforating vein insufficiency in 5 (7%).

CONCLUSIONS

Lower extremity venous segments showed different proportions of occlusion, partial recanalization, and total recanalization. Calf veins showed more rapid recanalization than proximal veins. Venous reflux was noted as early as 1 month. The limbs involving multisegment DVTs on initial examination had a higher incidence of deep vein insufficiency and could require much longer followup studies.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16038821

Citation

Yamaki, Takashi, and Motohiro Nozaki. "Patterns of Venous Insufficiency After an Acute Deep Vein Thrombosis." Journal of the American College of Surgeons, vol. 201, no. 2, 2005, pp. 231-8.
Yamaki T, Nozaki M. Patterns of venous insufficiency after an acute deep vein thrombosis. J Am Coll Surg. 2005;201(2):231-8.
Yamaki, T., & Nozaki, M. (2005). Patterns of venous insufficiency after an acute deep vein thrombosis. Journal of the American College of Surgeons, 201(2), pp. 231-8.
Yamaki T, Nozaki M. Patterns of Venous Insufficiency After an Acute Deep Vein Thrombosis. J Am Coll Surg. 2005;201(2):231-8. PubMed PMID: 16038821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of venous insufficiency after an acute deep vein thrombosis. AU - Yamaki,Takashi, AU - Nozaki,Motohiro, PY - 2004/12/01/received PY - 2004/12/21/revised PY - 2004/12/21/accepted PY - 2005/7/26/pubmed PY - 2005/9/7/medline PY - 2005/7/26/entrez SP - 231 EP - 8 JF - Journal of the American College of Surgeons JO - J. Am. Coll. Surg. VL - 201 IS - 2 N2 - BACKGROUND: The purpose of this study was to investigate patterns of venous insufficiency during a 12-month period after an acute deep vein thrombosis. STUDY DESIGN: Seventy limbs in 67 patients with an acute deep vein thrombosis (DVT) involving 147 anatomic segments were evaluated with duplex scanning at 1 month, 3 months, 6 months, and 1 year. Venous segments were examined whether they were occluded, partially recanalized, or totally recanalized, and the development of venous reflux was evaluated. RESULTS: The segments investigated were the common femoral vein (38 segments), femoral vein (33 segments), popliteal vein (36 segments), and calf veins (40 segments). There were 35 limbs with isolated DVT and the remaining 35 had multisegment DVT. At 1 year, thrombi had fully resolved in 76% of the segments, 20% remained partially recanalized, and 5% were occluded. The venous occlusion was most predominant in the femoral vein (21%) at 1 year. On the contrary, rapid recanalization was obtained in calf veins than in proximal veins at each examination (p < 0.01). Deep vein insufficiency was detected as early as 1 month after development of DVT, and the reflux was most predominant in popliteal veins (56%), followed by femoral veins (18%). No reflux was found in calf veins. Multisegment DVTs had a significantly higher incidence of deep vein insufficiency than single segment DVTs at 1 year. Development of superficial venous insufficiency was found in 5 limbs (7%) and perforating vein insufficiency in 5 (7%). CONCLUSIONS: Lower extremity venous segments showed different proportions of occlusion, partial recanalization, and total recanalization. Calf veins showed more rapid recanalization than proximal veins. Venous reflux was noted as early as 1 month. The limbs involving multisegment DVTs on initial examination had a higher incidence of deep vein insufficiency and could require much longer followup studies. SN - 1072-7515 UR - https://www.unboundmedicine.com/medline/citation/16038821/Patterns_of_venous_insufficiency_after_an_acute_deep_vein_thrombosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1072-7515(04)01547-9 DB - PRIME DP - Unbound Medicine ER -