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At least 19 recordsLinked to original sources
PubMed1984

Postphlebitic syndrome.

Postphlebitic syndrome occurs in 20 per cent of patients with deep vein thrombosis. Symptoms are nonspecific; they include heaviness, fatigue, pain, and vary from patient to patient. The signs of edema, skin pigmentation, dermatitis, varicosities, and ulceration are a result of the increased retrograde venous pressure secondary to the valve destruction by the phlebitic process. The aim of therapy is to improve venous support by graduated elastic stockings and to ensure good skin care and exercise.

Clothing↗
PubMed1989

Intermittent compression units for the postphlebitic syndrome. A pilot study.

The postphlebitic syndrome is a common affliction with limited therapeutic options. Patients who fail to respond to treatment with graded elastic compression stockings often develop a chronic pain syndrome manifested by intractable pain and swelling. Because lymphedema, a condition also associated with leg pain and swelling, has been successfully treated by intermittent compressive therapy with an extremity pump, we conducted a pilot study of compressive therapy in patients with severe postphlebitic syndrome. All five patients studied had dramatic improvement in symptoms and functional status without side effects. Although a large randomized trial is needed to properly evaluate compressive therapy, it appears to be very effective in selected patients.

Adult↗
PubMed1984

A combined study of the strain gauge plethysmography and I-125 fibrinogen leg scan in the differentiation of deep vein thrombosis and postphlebitic syndrome.

The fallibility of the clinical diagnosis of deep venous thrombosis (DVT) and postphlebitic syndrome has led to a variety of noninvasive diagnostic modalities, e.g, Doppler ultrasound, plethysmography, and radionuclide phlebography. The purpose of this study is to analyze the value of combined strain gauge plethysmography (SPG) and I-125 fibrinogen leg scanning in the differentiation of DVT and postphlebitic syndrome. Using strain gauge plethysmograph, 600 studies were performed on 502 patients. The maximum venous outflow (MVO) was calculated. An MVO of 20 cm3/100 cm3 of tissue/min or above was considered normal, and MVO of less than 20 cm3 was abnormal. Of those, 150 limbs had I-125 fibrinogen leg scan and venograms. Of 82 normal SPG, when compared with venograms, 75 were normal, five had postphlebitic syndrome, and two had DVT (97.6% true-negative). Sixty-eight legs had positive SPG, 46 of which had DVT (67.6% true-positive), 21 had postphlebitic syndrome (30.9%), and one was normal (1.5% false-positive). When rubber tourniquets were placed lightly on each leg between the strain gauge and the thigh cuff, 12 legs changed from positive SPG to negative SPG; 56 legs only had positive SPG. Forty-six of these had DVT (82.1% true-positive), nine had postphlebitic syndrome, and one was normal. When positive SPG was combined with positive leg scan, the accuracy raised to 95.6% (44 of 46 legs). If the SPG was positive but the leg scan was negative, the possibility of postphlebitic syndrome was most likely (8 of 10, i.e., 80%).

Adolescent↗
PubMed1991

Postphlebitic syndrome and general surgery: an epidemiologic investigation.

Of a random sample comprising 4581 subjects from The Copenhagen County, 3608 (79%) attended an interview and a general health examination. The subjects were defined as suffering from subjective postphlebitic syndrome if they claimed of lower extremity pain or cramps at rest and from objective postphlebitic syndrome if varicose veins, edema, lower extremity ulcers, or skin changes were present. By means of logistic regression analysis, subjective postphlebitic syndrome was found independently associated with previous thromboembolism, obesity, increasing age, female sex, hormonal therapy, varicose veins, and previous major abdominal surgery. Objective postphlebitic syndrome was associated with previous thromboembolism, obesity, former birthgiving, and high social status. The findings support the view that subclinical deep venous thrombosis in connection with previous surgery may give rise to symptoms in the lower extremities.

Adult↗
PubMedDate not supplied

[Physical capacity and some determining factors in the patient with the postphlebitic syndrome].

40 limbs from normal persons and 32 limbs from patients with postphlebitic syndrome were studied. The latter group was classified according to the phlebography in partial and total recanalized postphlebitic groups. The research was carried out with a strain gauge plethysmograph and an ergometric bicycle. The patients showed the greater values of the venous volume, the maximal venous outflow and the rate of venous refilling, specially, the patients with total recanalized postphlebitic syndrome; this suggest a greater degree of venous valve insufficiency and a loss of the viscoelastic properties of venous vascular wall. The peripheral resistance was greater in the postphlebitic groups and it suggests a higher sympathetic nervous tone. The physical working capacity was lower in the postphlebitic patients and no relation was observed between it and the plethysmographic parameters.

Adult↗
PubMed1994

Postphlebitic syndrome after hip arthroplasty. 43 patients followed at least 5 years.

We reviewed 43 patients using clinical scoring for evidence of postphlebitic syndrome at least 5 years after hip replacement. All had had a venogram as part of a screening study at the time of surgery. The postphlebitic syndrome was identified in 13 patients and was disabling in 6. The syndrome was present in 9 of the 11 patients with a venographically proven deep vein thrombosis (DVT) and in 4 of the 32 without DVT. Postphlebitic sequelae had developed despite anticoagulant therapy for the acute DVT. The postphlebitic syndrome following asymptomatic deep vein thrombosis is an important long-term complication of total hip replacement.

Anticoagulants↗
PubMed1988

Causalgic form of postphlebitic syndrome. A variety of reflex sympathetic dystrophy caused by acute deep thrombophlebitis.

The causalgic form of the postphlebitic syndrome or reflex sympathetic dystrophy resulting from acute deep thrombophlebitis is a relatively uncommon and, unfortunately, frequently unrecognized form of the postphlebitic syndrome. The usual signs of venous insufficiency are minimal, but severe burning pain is characteristic, usually increased by dependency. The diagnosis is confirmed by phlebography and the response to a lumbar sympathetic block. A lumbar sympathectomy produces permanent pain relief.

Acute Disease↗
PubMed1996

Postphlebitic syndrome: clinical activity and tolerability of desmin, new LMW dermatan sulfate.

One hundred patients suffering from postphlebitic syndrome of the lower limbs were enrolled in an open, randomized, and multicenter (six centers) trial for a period of eighteen months. Patients were randomly assigned to three treatment groups to receive (for ninety consecutive days) Desmin, a new low-molecular-weight dermatan sulfate, at the dose, respectively, of 100 mg once daily by subcutaneous (SC) route (36 patients), 100 mg twice a day by SC route (33 patients), and 200 mg once daily by intramuscular (IM) route (31 patients). The general and local tolerability and the clinical efficacy of the drug were evaluated by means of clinical, instrumental, and laboratory parameters. Desmin is effective in the decompensation stage of postphlebitic syndrome; this was demonstrated by a significant reduction in the severity of a number of typical symptoms as well as by the drug's positive effect on venous tone as confirmed by phlebotensiometric examination. The daily dose of 200 mg (either SC or IM) was more effective than the 100 mg dose. The results obtained at the end of the trial (ninety days) were statistically better than those obtained after thirty days of treatment. This trial demonstrated that both the systemic and the local (at the site of injection) tolerability of the drug, administered for three months, were good and without significant variations in the laboratory parameters monitored.

Adult↗
PubMed1997

[Heparan sulfate in the therapy of postphlebitic syndrome. Evaluation of the efficacy and tolerability as compared to mesoglycan].

BACKGROUND: Antithrombotics and profibrinolytics are indicated in several clinical thrombophilic conditions such as postphlebitic syndrome. Heparansulphate, a glycosaminoglycan, shows an antithrombotic activity with low anticoagulant effect. The aim of the study was to evaluate the efficacy and the safety of heparansulphate (100 mg b.i.d.) versus mesoglycan (50 mg b.i.d.), both administered for three months in patients with postphlebitic syndrome. METHODS: The trial was performed in an open-label, controlled, with parallel and randomized groups, design. Thirty patients, with chronic venous insufficiency and a history of venous thrombosis were enrolled. Coagulative and fibrinolytic parameters (PT, aPTT, euglobulin lysis time, fibrinogen, D-dimer, t-PA, PAI-1) and signs and symptoms (cramps, paresthesia, itch, edema, local pain, skin trophism) were assessed at enrollment, 15 days later after the pharmacological washout period and after 1, 2, 3 months of treatment. Safety was evaluated by monitoring any adverse event during the study and performing clinical laboratory tests at the beginning and at the end of treatment. RESULTS: The two drugs showed a superimposable efficacy and very good tolerability. Coagulative and fibrinolytic parameters were positively affected by both treatments and the clinical benefit was particularly evident in the heparansulphate group with a significant decrease "between times" of local pain, edema, paresthesia and itching. CONCLUSIONS: These data support the use of heparansulphate, and in general of glycosaminoglycans, in the postflebitic syndrome.

Drug Evaluation↗
PubMed1990

[Arteriovenous anastomoses in the treatment of postphlebitic syndrome of the lower extremities].

The authors describe an original method of putting arteriovenous end-to-end anastomosis between the distal fragment of the artery and central fragment of the vein in postphlebitic + syndrome of lower extremities. Operations were performed on 27 patients with different forms of the syndrome. Clinical improvement was obtained in 22 patients (81%), which was confirmed by findings of functional investigations. This operation was most effective in patients with recanalization or partly recanalized forms of the postphlebitic syndrome.

Adult↗
PubMed1982

Surgical treatment of postphlebitic syndrome with vein valve transplant.

Sequelae of the postphlebitic syndrome can new be treated by direct valve surgery. The present surgical treatment of stasis ulcer, including removal of the incompetent perforators, ulcer excision, and skin grafting, remains essential. Excision of perforators and ulcer care are effective but are associated with a high rate of ulcer recurrence. Experimental studies to restore venous valve function include autogenous or homologous vein valve transplantation, valvuloplasty, and valve transposition. In 23 cases of vein valve transplantation and two transpositions, a normal autogenous vein valve from the arm was used to restore a normal functioning venous valve in the leg. Pre- and postoperative noninvasive and invasive testing indicates hemodynamic improvement of venous function in these legs. Follow-up direct venous pressure measurements did not show normalization and may indicate that more than one competent valve is necessary. Changes in muscle structure may play a role in the maintenance of venous pressure.

Adult↗
PubMedDate not supplied

Antithrombotic treatment during acute inflammatory complications of patients affected by postphlebitic syndrome: LMW-heparin versus standard heparin.

Seventy seven patients affected by postphlebitic syndrome (PPS) during acute inflammatory and/or obstructive complications were controlled. Thirty nine patients were treated with a new low molecular weight heparin (Fluxum), 16,000 I.U. AXa/day subcutaneously for 10 days and, subsequently, 8,000 I.U. AXa/day subcutaneously for up to 50 days. Thirty eight patients were treated with 20,000 I.U./day i.v. for 10 days of sodium heparin and, subsequently, with 12,500 I.U./day of calcium heparin by subcutaneous injection for up to 50 days. Clinical symptoms (pain, oedema, hyperemia, rashes, itching, dermatitis, ulceration) and instrumental patterns (Doppler) were recorded. Fluxum had an evident effect on the improvement of patient's clinical performance during acute complications of PPS.

Aged↗
PubMed1991

Chronic femoral arteriovenous fistula masquerading as the postphlebitic syndrome.

A patient with a traumatic femoral arteriovenous fistula was misdiagnosed for 11 years as having "postphlebitic syndrome." Angiography revealed diffuse dilatation of the veins and arteries of the right lower extremity with the iliac vein measuring 16.0 cm in diameter and the cava 6.0 cm in diameter. Operative repair of the fistula has resulted in marked clinical improvement and return of the patient to fulltime employment. A history of trauma should be sought when a patient presents with unilateral chronic venous insufficiency.

Aneurysm↗
PubMed1986

Distribution of venous valvular incompetence in patients with the postphlebitic syndrome.

The records of 122 patients who underwent Doppler evaluation for the postphlebitic syndrome were reviewed to determine the relationship between location of venous valvular incompetence and severity of clinical signs. Categorized according to the most severe physical finding, there were 35 limbs with perimalleolar ulcers, 113 with stasis pigmentation, 26 with swelling, and 70 with no overt signs. Incompetent veins, either deep or superficial, were present in 93% of the symptomatic and 59% of the asymptomatic limbs. Proximal (iliofemoral) deep venous incompetence was not strongly correlated with disease severity (p less than 0.10), but distal (popliteotibial) deep venous and superficial venous incompetence were (both, p less than 0.0005). The relative frequency of isolated proximal incompetence appeared to diminish with increasing disease severity; whereas that of distal incompetence, with or without associated proximal venous incompetence, increased. Isolated proximal venous incompetence was found in only 5% of limbs with severe disease (ulcers or pigmentation). In limbs with severe signs, distal venous incompetence was present in 67% of those with proximal venous incompetence and in 57% of those in which the proximal valves were competent. These findings cast doubt on the potential value of proximal venous valvular reconstruction, especially in limbs with combined proximal and distal insufficiency.

Adolescent↗
PubMedDate not supplied

[Some considerations on the postphlebitic syndrome].

After a brief description of the aetiopathogenetic aspects of the phlebitic and postphlebitic syndrome, medical and surgical therapies for this syndrome are reviewed. A derivative of the phenybutazone group (Febutol) is then discussed and its considerable effectiveness emphasized.

Anticoagulants↗
PubMedDate not supplied

[A case of multiple arteriovenous fistulae in a postphlebitic syndrome of longterm evolution].

Authors report a case of a 77-years-old man who, after an accident of traffic on 1968, presented a left ileo-femoral deep venous thrombosis. Consequently, the patient suffered and important postphlebitic syndrome, with several varicose packs which were treated by surgical procedure in other centre. During several years, patient presented severe trophic diseases. Seventeen years after the beginning of his pathology, and during an angiologic examination, multiple arteriovenous fistulas at the left ileofemoral area have been shown. An skeletalization was impossible because of the severe ulcerations of the leg; so a left iliac arterial ligature and a Dacron Banding in primitive iliac artery, reducing a 50% the diameter, were made. The postoperative result was excellent, with an spectacular reduction of the fistulous communications and a complete remission of the cutaneous ulcerations.

Accidents, Traffic↗
PubMedDate not supplied

[Arteriovenous fistula in patients with a complicated postphlebitic syndrome].

An investigation, which goal is to evidencing AV fistulas in patients with a complicated postthrombotic syndrome, as well as to determinate the efficacy of noninvasive methods used for the study of AV fistulas in such patients, is presented. So, patients with a complicated postphlebitic syndrome interned into the Instituto de Angiología were studied. Twenty-five patients were included in the study, 9 of these patients (36%) had arteriovenous fistulas, arteriographically evidenced. Haemodynamic study do not support the evidence of such communications.

Arteriovenous Fistula↗