Long-term clinical and ultrasonographic evaluation of thrombophilic patients with deep venous thrombosis

Abstract

Objective: The purpose of this study was to evaluate the long term clinical and ultrasonographic outcomes of thrombophilic patients with deep venous thrombosis (DVT). Method: Cohort study, retrospective case-control with cross-sectional analysis. Thirty-nine thrombophilic patients and 25 non-thrombophilic patients were assessed 76.3 ± 45.8 months after diagnosis. Demographic and family data were collected, as well as data from clinical and therapeutic progress, and physical and ultrasound examinations of the limbs were performed. Groups were matched for age and gender and the variables studied were compared across groups. Results: Deep venous thrombosis was more frequent in women. The most common thrombophilias were antiphospholipid syndrome and factor V Leiden mutation. There was no difference between groups in terms of the number of pregnancies or miscarriages and the majority of women did not become pregnant after DVT. Non-spontaneous DVT prevailed. Proximal DVT and DVT of the left lower limb were more frequent, and the main risk factor was use of oral contraceptives. All patients were treated with anticoagulation. There was a higher frequency of pulmonary embolism in non-thrombophilic patients. Most patients considered themselves to have a "normal life" after DVT and reported wearing elastic stockings over at least 2 years. Seventy-one percent of patients had CEAP ≥ 3, with no difference between groups. Deep venous reflux was more frequent in thrombophilic patients. Conclusion: There were no significant differences between groups with respect to most of the variables studied, except for a higher frequency of pulmonary embolism in non-thrombophilic patients and greater frequency of deep venous reflux in thrombophilic patients.Keywords: deep vein thrombosis; thrombophilia; postthrombotic syndrome; pulmonary embolism; duplex scan. ResumoObjetivo: A proposta deste estudo foi realizar a avaliação clínica e ultrassonográfica em longo prazo de pacientes com diagnóstico de trombose venosa profunda (TVP), portadores de trombofilia. Método: estudo coorte, caso-controle retrospectivo com análise transversal. Foram estudados 39 pacientes portadores de trombofilia (PT) e 25 pacientes não portadores de trombofilia (PNT), dentro de um intervalo de tempo de 76,3 ± 45,8 meses, após o diagnóstico de TVP. Foram coletados dados demográficos e antecedentes familiares, assim como dados referentes à evolução clínica e terapêutica, tendo sido realizado também exame físico e ultrassonográfico dos membros envolvidos. Os grupos foram pareados quanto à idade e ao sexo, e as variáveis estudadas foram comparadas entre os grupos. Resultados: TVP foi mais frequente em mulheres. As trombofilias mais comumente encontradas foram a síndrome antifosfolípide e a mutação do fator V Leiden. Não houve diferença entre os grupos considerando-se o número de gestações e abortamentos, e a maioria das mulheres não engravidou após o episódio de TVP. A TVP não espontânea prevaleceu. A TVP proximal e em membro inferior esquerdo foi a mais frequente,...

Comparison of the mechanical properties and anchoring performance of polyvinylidene fluoride and polypropylene barbed sutures for tendon repair

“…Assessing adequacy of suture properties, a previous study reported that the force in the human flexor digitorum profundus and flexor digitorum superficialis tendons ranged 2–9 N during active extension and passive flexion and 2–19 N during active unresisted flexion, indicating that the tensile strength of the 2–0 barbed PVDF sutures (22.4 N) is more appropriate than the tensile strength of 2–0 barbed PP sutures (14.0 N) 33 . A previous study of only PP 2–0 barbed sutures reported an ultimate tensile force of 40 N, which was higher than the 14 N in our study 34 . This discrepancy can likely be explained by different barb cutting parameters, as our previous work showed that the peak tensile force decreased from 33 to 26 N when the cut depth increased from 0.07 to 0.18 mm with a constant cut angle of 160° 4,20 …”

“…33 A previous study of only PP 2-0 barbed sutures reported an ultimate tensile force of 40 N, which was higher than the 14 N in our study. 34 This discrepancy can likely be explained by different barb cutting parameters, as our previous work showed that the peak tensile force decreased from 33 to 26 N when the cut depth increased from 0.07 to 0.18 mm with a constant cut angle of 160 . 4,20 The strength of a tendon repair is governed by several factors, including, but not limited to, the configuration or suture pattern, number of strands crossing the repair, tensile strength of the suture, and suture pullout force, an indicator of the suture anchoring performance.…”