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Haemodynamics of the postphlebitic syndrome
C Schmidt1, J Schmitt, M Scheffmann
1Secteur d'Angiologie, Hôpital Central, Nancy, France.
Summary
Deep vein thrombosis (DVT) impairs venous function long-term, with reduced venous volume and outflow persisting despite initial treatment. Dynamic tests are better for assessing post-DVT venous changes and preventing post-phlebitic syndrome.
Area of Science:
- Vascular Medicine
- Medical Physiology
Background:
- Deep vein thrombosis (DVT) can lead to chronic venous insufficiency.
- Assessing long-term venous function post-DVT is crucial for managing the post-phlebitic syndrome.
Purpose of the Study:
- To evaluate long-term venous function after deep vein thrombosis (DVT).
- To compare the reliability of different plethysmographic methods for assessing post-DVT venous hemodynamics.
- To identify factors influencing functional recovery and the prevention of post-phlebitic syndrome.
Main Methods:
- Doppler ultrasound, strain gauge plethysmography (55 patients), and exercise plethysmography (10 patients) were used.
- Venous function was assessed over a mean period of 63 weeks post-DVT.
- Clinical and functional parameters were correlated.
Main Results:
- Significantly lower venous volume and outflow were observed throughout the study, irrespective of DVT location or initial therapy.
- No significant correlations were found between clinical and functional parameters, except in cases of proximal obstruction with popliteal valvular incompetence.
- Exercise plethysmography highlighted the role of the calf pump in post-phlebitic syndrome.
Conclusions:
- Static plethysmographic measurements are unreliable for long-term DVT prognosis.
- Dynamic venous function tests are superior for assessing hemodynamic changes after DVT.
- Dynamic tests aid in monitoring the effectiveness of post-phlebitic syndrome prevention strategies.