Management of the Postthrombotic Syndrome: The Rotterdam Approach

Wentel, Tim D; Neumann, H. A. Martino

doi:10.1055/s-2006-955469

Cited by 15 publications

(8 citation statements)

References 14 publications

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“…Once oedema has been reduced completely, class II MECS (23 to 32 mm Hg at B measurement) is prescribed to be worn for a period of 2 years. If, during the use of MECS, oedema is still present, class III MECS (34 to 46 mm Hg at B measurement) are prescribed [44]. MECS significantly reduce the development of postthrombotic syndrome.…”

Section: Treatmentmentioning

confidence: 99%

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Prospective Studies on Diagnosis, Prevention, and Management of Deep Vein Thrombosis (DVT), DVT Recurrence and the Post-Thrombotic Syndrome (PTS): From Concept to Study Design in the Primary Care Setting

Michiels¹

2014

Fam Med Med Sci Res

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Deep-Vein Thrombosis (DVT) Epidemiology DVT has an annual incidence of 0.2% in the urban population [1]. The disease is rare in children under 15 year of age, but its frequency increases with age, with an incidence of 1.8 per 1000 persons-years at age 65 to 69 years and 3.1 per 1000 persons-years at age 85 to 89 years [2,3]. First-time episodes of DVT are in two-thirds of cases elicited by risk factors, including cancer, immobility, or surgery. The prevalence of DVT is comparable in black and white adults and is low in Asian populations. Risk for DVT seems to be slightly higher in men than in women, and the risk of recurrence of venous thromboembolism is about 60% higher in men compared to women [4]. F a m ily Med ic in e & Me dica l S c ie n c e Resea rc h

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Section: Treatmentmentioning

confidence: 99%

“…The post thrombotic syndrome (PTS) is a chronic condition that affects the deep venous system, and may also extend to the supeficial venous system of the legs in patients with a documented history of deep vein thrombosis (DVT) [1,44,45].…”

Section: Post-thrombotic Syndrome (Pts) Definitionmentioning

confidence: 99%

Prospective Studies on Diagnosis, Prevention, and Management of Deep Vein Thrombosis (DVT), DVT Recurrence and the Post-Thrombotic Syndrome (PTS): From Concept to Study Design in the Primary Care Setting

Michiels¹

2014

Fam Med Med Sci Res

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“…A PTS will develop in 50 % of the patients after a deep vein thrombosis. (38) Based on the underlying disturbance in the venous hemodynamics, PTS may be divided into three different types (39):…”

Section: Non-re-canalized Thrombosismentioning

confidence: 99%

The recalcitrant venous leg ulcer – a never ending story?

Reeder¹,

Maessen-Visch²,

Langendoen³

et al. 2013

Phlebologie

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SummaryIntroduction: In general, four particular causes of recalcitrant venous leg ulcers may be distinguished. These are foot pump insufficiency, chronic venous compartment syndrome and non-re-canalized popliteal vein thrombosis. The fourth cause of recalcitrant venous leg ulcers is lipodermatosclerosis as a symptom of severe chronic venous insufficiency.Methods: We reviewed the literature and based on this we describe four main causes of recalcitrant venous leg ulcers and their specific treatment.Results: Foot pump insufficiency arises when the plantar foot veins are not able to empty. Treatment should consist of physical therapy, a mechanical foot pump device and an insole. Lipodermatosclerosis may be treated by excision and split-thickness skin grafting (Vigoni procedure). Chronic venous compartment syndrome is usually caused by post-thrombotic syndrome and treatment consists of a fasciectomy, but is rarely used nowadays. Patients with non-re-canalized popliteal vein thrombosis may be supported by intermittent pneumatic compression, walking exercises, alternate standing and walking with lying down. All patients with recalcitrant venous leg ulcers must wear medical elastic compression stockings with high stiffness and high compression lifelong.Conclusions: Patients with recalcitrant venous leg ulceration are challenging. More specific treatment will heal more of these ulcers.

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“…Both the deep and the superficial venous system contribute to the development of CVI. A special form of CVI is the postthrombotic syndrome (PTS) (13). In this case, CVI is caused by a deep venous thrombosis leading to valve destruction and or persistent obstruction.…”

Section: The Skinmentioning

confidence: 99%

Skin, Veins and Legs

Neumann¹

2011

Phlebologie

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SummarySkin, veins and legs are the three ingredients which compose together the symptom complex know as chronic venous insufficiency (CVI). High ambulatory venous pressure is transferred by simple physical laws to the skin microcirculation. The capillaries are not resistant to this high pressure and will leak water, erythrocytes and plasma proteins into the in-terstitium. The result is oedema, pigmentation, sclerosis, inflammation and ulceration. Although many forms of intervention for incompetent veins are available, compression therapy is still the cornerstone in the treatment of CVI. Beside the interface pressure, the stiffness of the compression material is essential. By increasing the stiffness the difference in pressure during walking increases and with this the massage effect of the therapy.Thermo-ablation is the treatment for varicose veins today. Knowledge about the development and transfer of the intravascular heat is essential to understand this treatment. New experiments, specially about steam development from the heat source in the blood are of great importance for the success rate. Fine tuning in those physical parameters is needed to optimally this treatment.

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Management of the Postthrombotic Syndrome: The Rotterdam Approach

Cited by 15 publications

References 14 publications

Prospective Studies on Diagnosis, Prevention, and Management of Deep Vein Thrombosis (DVT), DVT Recurrence and the Post-Thrombotic Syndrome (PTS): From Concept to Study Design in the Primary Care Setting

Prospective Studies on Diagnosis, Prevention, and Management of Deep Vein Thrombosis (DVT), DVT Recurrence and the Post-Thrombotic Syndrome (PTS): From Concept to Study Design in the Primary Care Setting

The recalcitrant venous leg ulcer – a never ending story?

Skin, Veins and Legs

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