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[Sequelae of deep venous thrombosis, 5-year follow-up of 341 patients]
Insights
Thrombolytic therapy shows potential in reducing post-thrombotic syndrome (PTS) after deep vein thrombosis. Early diagnosis and treatment, especially for extensive cases, are crucial for better outcomes.
Area of Science:
- Vascular Medicine
- Thrombosis Research
- Clinical Outcomes
Context:
- Deep vein thrombosis (DVT) can lead to long-term disability from post-thrombotic syndrome (PTS).
- Evaluating the long-term efficacy of thrombolytic therapy versus heparin in DVT patients.
- A 5-year observational study was conducted at the Department of Angiology, Hospital Cantonal of Basle.
Purpose:
- To determine if thrombolytic therapy reduces the incidence of post-thrombotic syndrome (PTS).
- To assess the relationship between thrombosis extent, therapy type, and PTS development.
- To identify high-risk groups and recommend prophylactic measures.
Summary:
- Out of 341 patients (208 received streptokinase, 133 heparin), 1 in 5 developed PTS after 5 years.
- PTS incidence correlated significantly with the extent of thrombosis; extensive cases had double the risk.
- Heparin was effective for leg-limited thrombosis, while thrombolytic therapy showed positive results in less extensive cases.
Impact:
- Findings underscore the necessity of prompt diagnosis and swift intervention for DVT to prevent extensive thrombosis.
- Prophylactic measures are recommended for high-risk patient groups.
- Thrombolytic treatment should be reserved for extensive DVT in young patients without contraindications, with careful monitoring.
Abstract:
In order to see whether thrombolytic therapy led to a reduction of CPT, a cause of long periods of inability to work, a study on the development of phlebothrombosis was carried out at the Department of Angiology at the Hospital Cantonal of Basle. Subjects presenting deep phlebothrombosis, either acute or sub-acute, were observed after 5 years... Or the 341 patients, 208 received streptokinase and 133 heparin. After the 5 years, 1 in 5 patients had developed CPT. The incidence of CPT was above all related to the extent of the thrombosis. If one considers not only the immediate therapeutic effect but also the extent of the thrombosis, then the incidence of CPT, especially in leg ulcers, is roughly twice as high in patients with extensive thromboses, and therapy is negative, as in the patients with thromboses limited to two stages only, in which group the therapy is positive. It has even been eliminated where the thrombosis had been limited to the leg. Prophylactic measures are therefore necessary in the groups at high risk. The diagnosis must be swift in order to commence correct therapy whilst the thrombosis is not as yet extensive. Heparin therapy seems to be enough for those thromboses limited to the leg. Whilst awaiting thrombolytic methods without serious side-effects, thrombolytic treatment should be reserved for extensive thromboses in young patients with no contraindications. It is a condition sine qua non that the patient and the parameters of coagulation should be monitored.