Incidence and cost burden of post-thrombotic syndrome

Ashrani, Aneel A.; Heit, John A.

doi:10.1007/s11239-009-0309-3

Cited by 252 publications

(156 citation statements)

References 90 publications

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“…However, contemporary research reported by several authors 25,34 who have employed CDM shows that the recanalization of thrombi in lower extremities with DVT is not a slow process, as was previously believed. Killewich et al have published evidence that lysis of the thrombus and recanalization of venous segments can be observed on CDM in the first week after initial diagnosis 35 .…”

Section: Discussionmentioning

confidence: 80%

“…The total additional cost of treating PTS, over 15 years, was approximately US $3,000 in the United States. Additionally, PTS was responsible for 74 to 81% of all DVT treatment costs 25 . A study that analyzed data from patients with diagnoses of PE or DVT estimated that on average health services in the United States spent US$7,000 per patient/year on PTS 25 .…”

Section: Postthrombotic Syndromementioning

confidence: 99%

“…Additionally, PTS was responsible for 74 to 81% of all DVT treatment costs 25 . A study that analyzed data from patients with diagnoses of PE or DVT estimated that on average health services in the United States spent US$7,000 per patient/year on PTS 25 . In Brazil, Ramacciotti et al calculated that average annual cost was US$ 400 for moderate cases and US$ 1,200 for more serious PTS cases 26 .…”

Section: Postthrombotic Syndromementioning

confidence: 99%

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Recanalization after acute deep vein thrombosis

2013

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The process of recanalization of the veins of the lower limbs after an episode of acute deep venous thrombosis is part of the natural evolution of the remodeling of the venous thrombus in patients on anticoagulation with heparin and vitamin K inhibitors. This remodeling involves the complex process of adhesion of thrombus to the wall of the vein, the inflammatory response of the vessel wall leading to organization and subsequent contraction of the thrombus, neovascularization and spontaneous lysis of areas within the thrombus. The occurrence of spontaneous arterial flow in recanalized thrombosed veins has been described as secondary to neovascularization and is characterized by the development of flow patterns characteristic of arteriovenous fistulae that can be identified by color duplex scanning. In this review, we discuss some controversial aspects of the natural history of deep vein thrombosis to provide a better understanding of its course and its impact on venous disease.Keywords: venous thrombosis; ultrasonography Doppler color; review literature as topic. ResumoO processo de recanalização das veias dos membros inferiores, após um episódio de trombose venosa profunda aguda em pacientes anticoagulados com heparina e inibidores da vitamina K, faz parte da evolução natural da remodelagem do trombo venoso. Esse complexo processo de remodelagem envolve a adesão do trombo à parede da veia, à resposta inflamatória da parede do vaso, levando à organização e subsequente contração do trombo, à neovascularização e à lise espontânea de áreas no interior do trombo. A presença de fluxo arterial espontâneo em veias com trombose recanalizada tem sido descrita como secundária à neovascularização e se caracteriza pelo desenvolvimento de fluxo com padrão de fístulas arteriovenosas, identificadas por meio de mapeamento dúplex colorido. Nesta revisão, são discutidos alguns aspectos controversos da história natural da trombose venosa profunda, para uma melhor compreensão da sua evolução e do seu impacto sobre a doença venosa.Palavras-chave: trombose venosa; ultrassonografia Doppler em cores; literatura de revisão como assunto.

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Section: Discussionmentioning

confidence: 80%

Section: Postthrombotic Syndromementioning

confidence: 99%

Section: Postthrombotic Syndromementioning

confidence: 99%

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Recanalization after acute deep vein thrombosis

2013

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“…In addition, post-thrombotic syndrome (PTS), which is a long-term sequela of DVT, aff ects 23 -60 % of patients and results in a high level of morbidity [1]. Several factors contribute to the development of VTE: alterations in blood fl ow, hypercoagulability of blood, and disruption of endothelial function [2].…”

Section: Introductionmentioning

confidence: 99%

Effects of rosuvastatin as an adjuvant treatment for deep vein thrombosis

Norberto

Gastambide

Taylor

et al. 2016

Vasa

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Summary:Background: Statins have been reported to help prevent the development and the recurrence of deep vein thrombosis (DVT). We conducted a prospective randomized clinical trial to compare the effects of rosuvastatin plus a low-molecular-weight heparin (LMWH), bemiparin, with conventional LMWH therapy in the treatment of DVT. Patients and methods: In total, 234 patients were randomized into two groups, 116 in the LMWH group and 118 in the statin plus LMWH group. All patients underwent lower limb duplex ultrasound and analytic markers at diagnosis and three months of follow-up. The fi nal analysis included 230 patients. Results: No signifi cant differences were observed in D-dimer levels after three months of follow-up between patients treated with LMWH+rosuvastatin compared to the LMWH group (802.51 + 1062.20 vs. 996.25 + 1843.37, p = 0.897). The group of patients treated with statins displayed lower levels of CRP (4.17 + 4.27 vs. 22.39 + 97.48, p = 0.018) after three months of follow-up. The Villalta scale demonstrated signifi cant differences between groups (3.45 + 6.03 vs. 7.79 + 5.58, p = 0.035). There was a signifi cant decrease in PTS incidence (Villalta score> 5) in the rosuvastatin group (38.3 % vs. 48.5%, p = 0.019). There were no differences in EuroQol score between groups. Conclusions: Adjuvant rosuvastatin treatment in patients diagnosed of DVT improve CRP levels and diminish PTS incidence.

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“…1 PTS is characterized by swelling, venous eczema, pigmentation, severe edema, venous claudication, chronic pain, and recurrent ulcers. 2 PTS is also associated with a significant health care cost, loss of economic productivity, and a deterioration in quality of life.…”

Section: Introductionmentioning

confidence: 99%

Rates of elastic compression stockings prescription following the diagnosis of deep venous thrombosis among Canadian emergency physicians and trainees

Kayssi

Petrosoniak

Levenstadt

et al. 2015

CJEM

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Introduction: Postthrombotic syndrome (PTS) is a complication of deep vein thrombosis (DVT) characterized by chronic pain, swelling, and heaviness, and may result in ulceration. Elastic compression stockings (ECS) worn daily after DVT have been shown to reduce the incidence and severity of PTS. The aim of our study was to investigate practices and perceptions of physicians regarding adjunct therapies to anticoagulation in patients diagnosed with lower extremity DVT. Methods: A national online survey was conducted of Canadian emergency medicine staff physicians and residents (n = 471) to investigate their attitudes toward the prescription of ECS post-diagnosis of DVT. A paper survey of patients in a thrombosis clinic (n = 58) was also administered to better understand the patient experiences with ECS. Results: The majority of staff physician (62%) and resident (69%) respondents were unsure of whether ECS were effective in preventing PTS and managing venous symptoms. Only 6% of staff physicians and 7% of residents routinely prescribed ECS for above-knee DVTs. More than 78% of respondents were unsure about the optimal timing of initiation of ECS and duration of therapy. Although all patients noted symptomatic relief with ECS, only 50% were prescribed stockings by an emergency or family doctor, and 69% of those patients wore the stockings on a daily basis. Staff physicians most frequently identified poor fit as the reason for lack of patient compliance, whereas patients most frequently cited cost. Conclusions: Our findings suggest that there is variability in practice among Canadian emergency medicine physicians and trainees and a need for widespread education regarding the latest evidence of the benefit of ECS after DVT.

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Incidence and cost burden of post-thrombotic syndrome

Cited by 252 publications

References 90 publications

Recanalization after acute deep vein thrombosis

Recanalization after acute deep vein thrombosis

Effects of rosuvastatin as an adjuvant treatment for deep vein thrombosis

Rates of elastic compression stockings prescription following the diagnosis of deep venous thrombosis among Canadian emergency physicians and trainees

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