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PubMedDate not supplied

[The value of Duplex sonography in the diagnosis of deep leg and pelvic vein thrombosis].

50 cases, in which phlebography was indicated by clinical symptoms of deep venous thrombosis, were examined by duplex-sonography. In comparison with the phlebographic findings, duplex-sonography was 100% sensitive in detecting thrombosis of the popliteal, femoral and iliac veins and 89% respectively 95% and 100% specific. A sonographic performance of the calf veins was only possible in 44%, the sensitivity in these cases was 92%, specificity 50%. Thus, the non-invasive duplex-sonography is a very appropriate method to diagnose thrombosis of the popliteal region and proximal. For proving or excluding thrombosis of the calf veins phlebography remains necessary.

Adolescent↗
PubMed1988

[Acute phlebographic diagnosis of thrombotic complications in gynecology and obstetrics].

From 1971 to April 1986 phlebography was performed in a total of 459 patients suspected clinically having an acute phlebothrombosis. From 112 female patients (24.4%) coming from the departments of gynaecology and obstetrics in 94 cases an acute or subacute phlebothrombotic process was proved phlebographically. The main age of these female patients was 29 +/- 11 years (17 to 76 years). A combined ileo-femoral-crural vein thrombosis in 44.7% was the most frequent localization and expansion, however, an isolated thrombotic process of pelvic veins was found in 25.6% only. A coincidence of the calculated age of thrombosis and clinical symptoms could be proved in 62 female patients (66%), but often the phlebographically calculated thrombus age was much longer than suspected by clinical symptoms alone. Foudroyant pulmonary embolism was observed in each fifth or sixth patient. The special technique of phlebographic investigation is discussed in detail with the judgement of a differentiated therapy of phlebothrombosis and pulmonary embolism.

Adolescent↗
PubMed1988

[The rehabilitation of patients with trophic ulcers of the legs in a polyclinic].

The author's experience with observation of 200 patients shows that complex treatment of trophic ulcers of lower extremities under conditions of polyclinic including zinc-gelatin bandage and phlebectomy, facilitates better use of hospital beds, increases their effectiveness and is of economic and social significance because of the total dispensary examination of population.

Ambulatory Care↗
PubMedDate not supplied

[Pressure therapy using a mercury bath. Indications, results].

In the scope of lymphatic and veno-lymphatic pathology, in order to soften the limbs with a maximum effectiveness so that the lymphatic structures will be more operational, this pressotherapy consists in using the properties of mercury, high density fluid, to realize a compressive and progressive, painless cast, adjusted to the form of the limb. Usually, the limb is placed vertically in a treatment tank where mercury is introduced, according to certain modalities; to reach variable and programmed levels. This preliminary study shows that the method, with good results ranging between 75 and 85 p. cent, is indicated in the treatment of all lymphedemas, the treatment of venolymphatic edemas, post-phlebitic sequelae, treatment of hypodermatitis and persistent ulcers due to primary venous insufficiency or phlebitis sequelae (and even, with other protocols, in arterial pathology).

Adolescent↗
PubMedDate not supplied

[Prevention and therapy of deep venous thromboses in pregnancy].

This paper presents a review of the current status of prevention and treatment of thromboses in pregnancy and reports the author's own results. Thromboembolism prophylaxis during pregnancy is accomplished with low-dose heparin, and is recommended for patients with a history of thrombosis and/or embolism. Heparin does not permeate the placenta; therefore, long-term use of it in low doses does not involve a risk. Complication-free courses in 18 pregnancies during which low-dose heparin was administered by the author are described. In cases of manifest deep thrombosis in the iliofemoral vein during pregnancy it is advisable today to perform thrombectomy as an alternative to fibrinolysis. This is followed by continuous administration of heparin in a therapeutic doses. Primary heparin treatment is given for thromboses of the knee and lower leg. The individual therapeutic methods are compared on the basis of information in the literature and the author's personal experience with 34 cases. Coumarins should no longer be used during pregnancy. In view of the risk of osteoporosis under high-dose long-term heparinization, one should switch to coumarins as soon as possible post partum; the coumarins are only detectable in traces in the mother's milk. Deep thromboses during pregnancy can only be treated with some promise of success if there is optimal cooperation between gynecologist, hemostasiologist and, if necessary, a vascular surgeon.

Combined Modality Therapy↗
PubMedDate not supplied

[Sequelae of deep venous thrombosis, 5-year follow-up of 341 patients].

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.

Female↗
PubMedDate not supplied

Advance in phlebology in Japan.

Vascular surgery has recently been witnessing remarkable progress in Japan, supported in part by an increase in the number of researchers. Although the actual researchers specializing in the field of phlebology are much fewer in Japan as opposed to the West because of a seemingly lesser number of patients suffering from venous diseases particularly those which are fatal, the participants in the annual meetings of the Japanese Society of Phlebology have shown a gradual increase since 1980. Notably, the 9th World Congress of Phlebology was held in late September 1986 in Kyoto with a great many global authorities giving lectures, presenting papers and discussing a wide range of topics with the 600 participants attending. This event markedly stimulated our phlebologists and will undoubtedly contribute to enhancing the level of phlebology in Japan. This positive environment was also given an earlier boost in 1985 by the Japanese Ministry of Health and Welfare establishing a study group for angiology including phlebology and lymphology. The activity of this group may be a important foundation for the most significant advances in phlebology in Japan.

Humans↗
PubMed1986

Long-term hemodynamic and clinical sequelae of lower extremity deep vein thrombosis.

Forty-seven patients with phlebographically confirmed lower extremity deep vein thrombosis (DVT) were reexamined 5 to 10 years (mean, 7 years) after the thrombotic event. Clinical symptoms were recorded and the following noninvasive venous vascular laboratory tests were performed: Doppler examination to determine venous valve competence and photoplethysmography to measure ambulatory venous pressure and venous recovery time. Twenty-eight control subjects underwent similar examination. Although only 10 of 47 patients (21%) were asymptomatic, venous ulceration had developed in only two patients. The symptomatic patients had varying degrees of edema, pigmentation, and varicosities. Eighty-three percent of DVT patients had abnormal vascular laboratory findings. Both the severity of clinical symptoms and the magnitude of the hemodynamic abnormalities generally correlated with the extent of the initial thrombus. However, only 47% of patients whose initial thrombus appeared limited to the calf were asymptomatic, and only 25% of this group had normal venous hemodynamic findings. This study indicates that 5 to 10 years after lower extremity DVT 80% of patients will have both symptoms and abnormal venous hemodynamics regardless of the initial site of the thrombosis.

Female↗
PubMedDate not supplied

[Efficacy of O-(beta-hydroxyethyl)-rutosides in the treatment of venous leg ulcers].

In a prospective 6 weeks study, done in 3 phlebology practices on 107 patients presenting an acute leg ulcer, we compared the efficacy of a combination of compression and HR (O-(Beta-hydroxyethyl)-rutosides with compression alone, based on objective and subjective parameters. These objective and subjective parameters are improved in both groups. A statistically significant superiority of the therapeutic combination is demonstrated in the cure of ulcers.

Bandages↗