Predicting Post-Thrombotic Syndrome with Ultrasonographic Follow-Up after Deep Vein Thrombosis: A Systematic Review and Meta-Analysis

Abstract

The US features reflux and residual thrombosis measured at least 6 weeks after DVT predict PTS. Whether these features may be used to identify patients who may benefit from compression therapy remains to be assessed in further studies.

Elastic compression stockings for prevention of the post-thrombotic syndrome in patients with and without residual vein thrombosis and/or popliteal valve reflux

“…Indeed, in the absence of longstanding vascular damage venous hypertension and subsequently PTS are unlikely to occur. 9,14 This is also consistent with the demonstration that PTS is unlikely to develop in individuals with a limited thrombotic burden and in those with isolated calf DVT. 1 Our results are robust, as they are based on a prospective observation of patients with proximal DVT who were followed-up for up to three years.…”

“…Recently, a hypothesis-generating meta-analysis showed a more than two-fold higher incidence of PTS in patients with ultrasound evidence of RVT at least 6 weeks after the index DVT. 9 In patients with PVR, the incidence of PTS was also increased but only by one-third. In hindsight, this small increase could be easily explained by the confounding effect of RVT that can also occur in combination with PVR.…”

“…8 A recent systematic review showed that patients with DVT who at 6 weeks or later had either residual vein thrombosis (RVT) or popliteal valve reflux (PVR) had a higher risk of subsequent PTS than those without these findings. 9 As these ultrasound features are associated with longstanding venous hypertension that could be modified by compression therapy, 10 the early identification of RVT and PVR has the potential to identify a subgroup of patients who may still benefit from use of ECS.…”

Upper Extremity Deep Vein Thrombosis: Current Knowledge and Future Directions

“…This is partially based on evidence in proximal lower limb DVT where residual thrombosis predicts for PTS 112 and efforts to reduce this through thrombolysis are modestly beneficial. 113 While in the lower limb there are validated PTS scores such as the Villalta score 114 and evidence that residual thrombosis predicts for PTS, 115 this area in the upper limb needs further research. In the upper arm, a modified Villalta score has been used in pilot studies, 6,106 applying the validated score for lower limb PTS to the upper arm.…”

Stent Thrombosis after Endovascular Treatment of Iliofemoral or Caval Veins in Patients with Postthrombotic Syndrome

“…2 PTS is associated with a significant financial and morbidity burden, and reduced patient-reported health quality of life measures. 1,2 There have been considerable efforts in improving the prediction [3][4][5] and prevention [6][7][8] of PTS in recent years. Indeed, the prevention of PTS has focused on use of external compression stockings, different forms of antithrombotic therapy, anti-inflammatory drugs, and acute endovascular interventions such as catheter-directed thrombolysis, all of which have provided conflicting results about efficacy.…”