Hemodynamic and clinical assessment after therapy for acute deep vein thrombosis. A prospective study

This prospective study was undertaken in 153 patients who had sustained DVT of various extents and had been treated with streptokinase or heparin. Its aim was (1) to assess hemodynamic changes occurring in the deep venous system over a 2 year period, and (2) to correlate these hemodynamic changes with the clinical features that subsequently developed. Foot volumetry, a noninvasive, objective, and accurate technique, was used to measure hemodynamic changes. Within 2 years of DVT, there was severe hemodynamic impairment (equivalent to that seen in established postphlebitic limbs) in a fifth of the limbs with calf vein DVT, and in half of the limbs with more extensive proximal DVT. Symptoms were worse after major DVT. Even when successful, thrombolytic therapy does not prevent hemodynamic deterioration. The results appear to be no better than for a group of patients who, with the same degree of thrombosis, received heparin therapy.