Residual vein thrombosis and trans-popliteal reflux in patients with and without the postthrombotic syndrome

The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

“…Prandoni et al 27 found that PTS developed more frequently in patients who had persistent venous obstruction within the first 6 months after an episode of acute proximal DVT (relative risk [RR], 1.6; 95% confidence interval [CI], 1.0-2.4), a result that was replicated by the same group in a second study. 28 Similarly, Roumen-Klappe et al 29 reported that persistent venous obstruction was an important predictor of PTS 3 months after DVT (RR, 1.7; 95% CI, 1.0-2.2). In the Catheter-Directed Venous Thrombolysis Trial (CaVenT), which assessed the efficacy of catheter-directed thrombolysis (CDT) using alteplase in patients with acute DVT extending above the popliteal vein, the absolute risk of PTS was reduced by 14.4% (95% CI, 0.2-27.9) in the CDT group.…”

“…7,8,47,51,73,75 Residual thrombosis after treatment of DVT has also been shown to be a predictor of PTS. 27,28,62,76 In patients with a first episode of DVT, the risk of PTS was 1.6-fold higher (95% CI, 1.0-2.5) in those with residual proximal thrombosis compared with those without this finding. 62 A recent study by Comerota et al 76 documented a statistically significant correlation between residual thrombus after CDT and PTS severity.…”

“…28 The RR of PTS (assessed with the Villalta scale) was 1.92 (95% CI, 1.39-2.64) in patients with residual vein thrombosis alone, 1.11 (95% CI, 0.66-1.89) in patients with popliteal valve incompetence, and 1.83 (95% CI, 1.26-2.66) in patients with both findings, suggesting that residual vein thrombosis is a stronger determinant of PTS.…”

“…164 Among a total of 977 patients with UEDVT/lower-extremity DVT, the weighted mean frequency of PTS was 26% (95% CI, [23][24][25][26][27][28]. When restricted to the 9 prospective analyses, [165][166][167][168][169][170][171][172][173] this frequency was 17% (95% CI, [14][15][16][17][18][19][20].…”

Postthrombotic syndrome and other outcomes of lower extremity deep vein thrombosis in children

“…Lack of DVT resolution was associated with PTS in children with LE-DVT in 1 previously reported pediatric study, and residual thrombosis is a known predictor of LE-PTS in adult patients. 15,[23][24][25][26] In addition, we found an interaction between sex and DVT trigger: (1) male sex was associated with a higher risk of PTS as compared with the female sex in the LR group, but this was not the case in the Non-LR group; and (2) Non-LR DVT were associated with a larger increase in risk of PTS as compared with LR-DVT among females, but this was not the case among males. The research on the association between sex and PTS in adult patients has yielded inconsistent results, and remains unclear.…”