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Importance of valvular incompetence after acute deep venous thrombosis
C J LeSiege1, S C McKean, A V Persson
1Section of Vascular Medicine and Hypertension, Lahey Clinic Medical Center, Burlington, Massachusetts.
Insights
Deep venous thrombosis (DVT) patients treated with anticoagulation showed varied outcomes. Valvular incompetence correlated with symptoms, while collateral channels and recanalization led to asymptomatic recovery.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
Background:
- Deep venous thrombosis (DVT) is a significant vascular condition.
- Color Doppler ultrasound is a key diagnostic tool for DVT.
Purpose of the Study:
- To evaluate long-term outcomes in patients with acute deep venous thrombosis (DVT).
- To identify factors predicting symptomatic versus asymptomatic recovery after DVT treatment.
Main Methods:
- Color Doppler ultrasound was used to diagnose DVT in 14 patients.
- Patients received heparin followed by warfarin therapy.
- Follow-up examinations occurred between 24 and 48 months.
Main Results:
- Six patients remained symptomatic, while eight were asymptomatic at follow-up.
- Asymptomatic patients often developed collateral channels or had superficial femoral vein recanalization without valvular incompetence.
- Valvular incompetence was present in all symptomatic patients.
Conclusions:
- Long-term DVT outcomes are influenced by venous recanalization, collateral formation, and valvular function.
- The presence of valvular incompetence is a strong predictor of persistent symptoms in DVT patients.
Abstract:
The color Doppler scanner was used to analyze acute deep venous thrombosis in 14 patients. A thrombus was found in the superficial femoral vein in 4 patients and in the superficial femoral and popliteal veins in 6 patients; a popliteal occlusion was found in 4 patients. All 14 patients were treated with intravenous heparin followed by at least 3 months of warfarin therapy. Patients were re-examined between 24 and 48 months. Six patients were symptomatic; 8 were asymptomatic. Five patients had occluding thrombus in the distal popliteal vein; major competent collateral channels developed from the proximal superficial femoral vein, and they remained asymptomatic. Three patients whose superficial femoral veins recanalized without valvular incompetence were asymptomatic. Valvular incompetence was observed in all of the symptomatic patients. Patients with persistent popliteal occlusion and collateral channels have fewer symptoms than patients with valvular incompetence in the superficial femoral and popliteal veins.