Long Term Follow-up of Deep Vein Thrombosis in the Lower Extremities.
- Author:
Seung Jae BYUN
1
;
Kwon Mook CHAE
;
Kyung Keun LEE
;
Byung Suk ROH
;
Kwon Ha YOON
;
Byung Jun SO
Author Information
1. Department of Sugery, Wonkwang University College of Medicine, Iksan, Korea. sobjun@wonnms.wonkwang.ac.kr
- Publication Type:Original Article
- Keywords:
Deep vein thrombosis;
Long term follow-up
- MeSH:
Catheters;
Female;
Follow-Up Studies*;
Hemodynamics;
Humans;
Lower Extremity*;
Prognosis;
Thrombosis;
Urokinase-Type Plasminogen Activator;
Venous Thrombosis*;
Warfarin
- From:Journal of the Korean Society for Vascular Surgery
2000;16(1):98-103
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To learn the long-term prognosis of patients with deep vein thrombosis (DVT), we evaluated the location and extent of thrombotic changes, hemodynamic status and clinical symptoms of patients of more than 12 months after development of acute thrombosis. METHODS: 31 patients (man; 24, female; 7, mean age; 44.7 13.2 years) with phlebograpically documented DVT were followed-up for 13~90 months (mean: 32.6 20.4 months) with Duplex scanning, and photo-plethysmography (PPG), and clinical symptoms. To evaluate the effects of treatment modality, the patients were devided into 3 groups; Group 1 (heparine warfarin, n=17), Group 2 (heparine warfarin catheter directed urokinase, n=10), Group 3 (heparine warfarin systemic urokinase, n=4). But, the size of Group 3 was inappropriate to compare with other groups, we performed analysis of the results of Group 1 and 2. RESULTS: Remained thrombi were detected in 22 patients (70.2%) of 31 patients by Duplex scanning, even 1 year later. Of the 29 patients studied with PPG, 24 patients (83%) revealed valvular incompetence in deep (11 cases, 38%) and superficial venous systems (13 cases, 45%). Thrombolytic rate in Group 2 was much higher than Group 1; complete resolution (40% vs 23%), complete obstruction (0% vs 41%). The statistically significant correlation between resolution degree and symptomatic improvement was shown (p=0.008). CONCLUSION: Residual thrombi and valvular damages after DVT were common. But, thrombolysis by catheter-directed urokinase may be associated with a higher rate of thrombolysis and clinical improvement. Anticoagulation alone may not be a sufficient method for treatment of DVT.
