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Venous reflux in patients with previous deep venous thrombosis: Correlation with ulceration and other symptoms

Labropoulos, N., Leon, M., Nicolaides, A.N., Sowade, O., Volteas, N., Ortega, F., Chan, P. (1994) Venous reflux in patients with previous deep venous thrombosis: Correlation with ulceration and other symptoms. Journal of Vascular Surgery, 20 (1). pp. 20-26. ISSN 0741-5214. (doi:10.1016/0741-5214(94)90171-6) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:78352)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided.
Official URL:
https://doi.org/10.1016/0741-5214(94)90171-6

Abstract

Purpose: Deep vein thrombosis (DVT) in many cases leads to chronic symptoms in the damaged leg, even though the affected veins have recanalized. The major hemodynamic defect in such recanalized veins is reflux. The incidence and extent of reflux has been studied in patients with proven DVT and correlated with concurrent symptoms. Methods: Two hundred seventeen limbs in 183 patients were examined by duplex scanning from January 1989 to October 1992. All limbs had previous DVT diagnosed by venography. Sites and extent (proximal, distal, or both) of reflux were identified by meticulous duplex scanning of the whole venous system and correlated with presenting symptoms. Results: The patients were classified into nine groups on the basis of the classification of the system involved (superficial, deep, or superficial and deep) and whether the reflux was found proximal or distal to the knee or both. Eighty-one limbs belong to chronic venous insufficiency class 1, 92 belong to class 2, and 38 belong to class 3. Reflux was confined to the deep venous system in 84 limbs (38.7%), to the superficial system in 31 (14.3%) limbs, and to both systems in 102 (47%) limbs. It was confined to proximal veins only in 48 (22.1%) limbs, distal only in 56 (25.8%) limbs and throughout the limb in 113 (52.1%) limbs. The incidence of swelling was increased by distal or a combination of proximal and distal reflux regardless of which system was involved. In limbs with superficial venous insufficiency (SVI) or deep venous insufficiency (DVI) only, the incidence of skin changes was not affected by the extent of reflux. However, in limbs with combined SVI and DVI, it was increased in the presence of reflux throughout the limb. Absence of distal reflux was associated with a low incidence of skin changes even in the presence of DVI. Ulceration increased with an increased extent of reflux in the presence of SVI. Absence of superficial reflux was associated with a low incidence, even in the presence of DVI. Conclusions: The data suggest that as far as the skin changes and ulceration are concerned, distal reflux and reflux in the superficial veins are more harmful than reflux confined to the deep veins, even when such reflux extends throughout the deep venous system.

Item Type: Article
DOI/Identification number: 10.1016/0741-5214(94)90171-6
Uncontrolled keywords: adolescent, adult, aged, article, claudication, deep vein thrombosis, female, human, leg edema, leg ulcer, leg vein, major clinical study, male, priority journal, skin defect, varicosis, vein insufficiency, Adolescent, Adult, Aged, Aged, 80 and over, Edema, Female, Femoral Vein, Human, Male, Middle Age, Plethysmography, Postphlebitic Syndrome, Regional Blood Flow, Saphenous Vein, Skin
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Depositing User: Philip Chan
Date Deposited: 07 Nov 2019 16:27 UTC
Last Modified: 14 Dec 2023 04:15 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/78352 (The current URI for this page, for reference purposes)

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