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Related Experiment Videos

Definition of the post-thrombotic syndrome, differences between existing classifications.

D N Kolbach1, H A M Neumann, M H Prins

  • 1Department of Epidemiology, University Maastricht, Maastricht, The Netherlands. dinanda.kolbach@epid.unimaas.nl

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|July 13, 2005
PubMed
Summary

No single definition effectively diagnoses post-thrombotic syndrome (PTS) after deep vein thrombosis (DVT). This study compared five PTS definitions, finding significant variations in prevalence and severity grading, with no clear advantage for any single system.

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Area of Science:

  • Vascular Medicine
  • Clinical Diagnosis
  • Medical Informatics

Background:

  • Established diagnostic criteria exist for deep vein thrombosis (DVT).
  • A uniform definition for diagnosing and treating post-thrombotic syndrome (PTS) remains elusive.
  • This study investigates various PTS definitions and their correlation with invasive venous pressure measurements.

Purpose of the Study:

  • To evaluate and compare five distinct clinical definitions of post-thrombotic syndrome (PTS).
  • To assess the relationship between these clinical definitions and invasive ambulatory venous pressure measurements.
  • To determine if any single classification system offers a superior method for diagnosing PTS.

Main Methods:

  • 124 patients with a history of DVT were clinically evaluated using five different PTS grading systems: Widmer, CEAP, Venous Clinical Severity Score (VCS), Prandoni, and Brandjes.

Related Experiment Videos

  • Both lower limbs were assessed for PTS severity.
  • Clinical scores were compared against invasive ambulatory venous pressure measurements.

    • Main Results:

    • Prevalence of severe PTS in DVT legs ranged from 7% to 21%, compared to 0-4% in control legs.
    • The Brandjes and VCS definitions tended to classify more legs as severe PTS.
    • All tested clinical definitions showed a significant association with ambulatory venous pressure, but substantial overlap existed between clinical groups, indicating limitations in the reference standard.

    Conclusions:

    • All evaluated clinical definitions of PTS correlate with ambulatory venous pressure measurements.
    • Significant differences were observed in how scoring systems discriminated between DVT and control legs, and in the reported prevalence of PTS.
    • No single classification system demonstrated a clear advantage over the others for diagnosing PTS.