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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical diagnosis of deep venous thrombosis appears as uneasy, because of inconstant and non-specific symptoms. When studying a phlebitis, the risk to diagnose venous thrombosis is over 50 p. 100. This review of 102 patients, supposed to present with phlebitis, confirms such data. The diagnosis reliability depends mainly on the physician's experience. Examination and clinical research, combined with Doppler data make possible to perform a good diagnosis in 4 cases out of 5. However, in 20 p. 100, phlebography is strongly required, appearing as an essential examination. Analysis of epidemiologic and clinical data demonstrates the importance of certain data as for the diagnosis: female sex, age superior to 60 years, existence of two antecedents and/or a cardiopathy, a complex clinical picture might demonstrate a diagnosis of deep venous thrombosis. Post-phlebitic syndrome and skin infectious pathologies are the main pseudophlebitis etiologies. Popliteal cyst (often mentioned in English literature as a pseudophlebitis factor) is diagnosed in 11 p. 100 of cases.
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PMID:[Pseudophlebitis of the lower limbs. A critical study from 102 suspected cases of deep venous thrombosis]. 381 84

Certain non-invasive techniques like Doppler CW and strain gauge plethysmography are highly effective ways of evaluating the natural history of postphlebitic syndrome. 40 patients of both sexes, average age 51.5 +/- 6.9 with a history of deep venous thrombosis (28 documented phlebographically) were subjected to Doppler tests with assessment of venous blood pressure and bilateral strain gauge plethysmography. 34 of the 40 suspected PPS cases were confirmed, though not all cases were at the same stage. Persistent deep venous thrombosis was found in five of the extremities and the last one examined revealed a primary varicose syndrome. A comparison of the Doppler and phlebography results showed both to be highly sensitive techniques (100% accuracy). When the contralateral limbs were examined, the Doppler technique revealed 7 cases of PPS and 21 primary varices. In contrast strain gauge plethysmography identified all 28 cases of increased venous capacitance as primary varices, thus confirming the inability of this technique to distinguish between the various varicose conditions. Assuming the presence of a vascular diagnosis laboratory where both techniques are available, strain gauge plethysmography is recommended as the examination of choice. This technique is simple and fast to perform and can provide extensive information whether at rest (filling and emptying volumes and times; venous tone and distensibility, venous blood pressure at rest) or in movement (venous pressure when standing, muscular pumping index). Hence plethysmography can reveal any canalisation present even in the earliest stages though it cannot pinpoint the precise site of the deep obstruction. The longer, more complex Doppler CW procedure should be reserved for secondary investigations. This technique is preferable to plethysmography when a more accurate assessment of the degree, site and extension of the venous recanalisation is needed. Doppler CW also provides information on any valvar sequelae since it records the direction of the blood flow in the presence of a substitution syndrome (increased venous flow in the surface vessels). Finally if used in a rational manner the two techniques can be combined to eliminate contrast medium techniques, which would only be adopted as a preoperative measure.
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PMID:[Doppler ultrasound and strain gauge plethymography in the diagnosis of the post-phlebitic syndrome]. 390 50

Thrombovascular disease represents one of the most important causes of morbidity and mortality. Although coronary artery disease attracts most attention, other types of vascular disease also make a substantial contribution to the overall statistics. These include microangiopathy, particularly in relation to diabetes mellitus, and deep vein thrombosis and its associated complications of pulmonary embolus and postphlebitic syndrome.
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PMID:Thrombotic vascular disease. 401 10

Light reflection rheography (LRR) is a new technique for quantitative diagnostics of venous functions. It is non-invasive, easy to handle, well-suited for repetition and standardization, and there is no strain for the patient. This method is appropriate for global assessment of calf pump insufficiency regardless whether it may be caused by varicosis, postphlebitic syndrome, or deep venous thrombosis. With the application of tourniquets, LRR helps to predict the possible result of vein stripping and is likewise useful for the follow-up period. LRR promises to become a valuable screening method regarding the detection of deep venous thrombosis of the lower leg. A useful methodic variation is the passive manual compression of the calf instead of active dorsiflexion; thus the measurement becomes independent of the patient's cooperation. We must take into account, however, the high sensitivity of LRR depending on various known and still unknown factors. The measured values may differ to a considerable degree in one single patient, even under exact conditions of examination. Therefore we always perform three measurements and then take the average value. Critically applied, LRR represents a valuable technique of quantitative phlebological examination.
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PMID:[Light-reflexion rheography--possibilities and limitations]. 409 May 75

Previous research has shown that MVO (Maximum Venous Outflow), VR (Venous Reflux), VE (Venous Emptying) and the respiratory waves recording are useful in differentiating occlusion and recanalization in postphlebitic syndrome. In the present work strain-gauge plethysmography was employed to quantitate the venous function after deep venous thrombosis of the legs. The studies were performed in a vascular laboratory with controlled temperature (23 to 25 C); records were obtained by a plethysmograph Parks mod. 270 connected to a Hewlett-Packard multi-channel mod. 7700. 17 patients (12 males, 5 females), mean age 55 years (range 24-75) that presented femoropopliteal thrombophlebitis documented by phlebography at the admission to the hospital were examined. MVO with and without superficial veins occlusion was measured by a mercury in silastic strain-gauge placed circumferentially about the calf. A pneumatic cuff thigh was inflated to 60 mm Hg. VE was measured in patients lying in inclined bed with the lower extremities 100 cm below the heart level compressing the calf with a pneumatic cuff 10 times for 5 seconds; the strain-gauge was placed on the foot level. VR after Valsalva's maneuver and the respiratory waves were recorded by a strain-gauge positioned at the maximum girth about the calf in patients lying on inclinated bed with the lower extremities 50 cm below the heart level. The result are here indicated: (Table: see text) There was differences in the evolution of venous function after deep venous thrombosis of the legs for each patient. Strain-gauge plethysmography may become evaluable non invasive technique in the evaluation of deep venous thrombosis evolution in the legs. The therapeutic assessment of postphlebitic syndrome.
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PMID:[Strain-gauge plethysmography in the evaluation of the evolution of deep vein thrombosis of the legs]. 647 45

The fallibility of the clinical diagnosis of deep venous thrombosis (DVT) and postphlebitic syndrome has led to a variety of noninvasive diagnostic modalities, e.g, Doppler ultrasound, plethysmography, and radionuclide phlebography. The purpose of this study is to analyze the value of combined strain gauge plethysmography (SPG) and I-125 fibrinogen leg scanning in the differentiation of DVT and postphlebitic syndrome. Using strain gauge plethysmograph, 600 studies were performed on 502 patients. The maximum venous outflow (MVO) was calculated. An MVO of 20 cm3/100 cm3 of tissue/min or above was considered normal, and MVO of less than 20 cm3 was abnormal. Of those, 150 limbs had I-125 fibrinogen leg scan and venograms. Of 82 normal SPG, when compared with venograms, 75 were normal, five had postphlebitic syndrome, and two had DVT (97.6% true-negative). Sixty-eight legs had positive SPG, 46 of which had DVT (67.6% true-positive), 21 had postphlebitic syndrome (30.9%), and one was normal (1.5% false-positive). When rubber tourniquets were placed lightly on each leg between the strain gauge and the thigh cuff, 12 legs changed from positive SPG to negative SPG; 56 legs only had positive SPG. Forty-six of these had DVT (82.1% true-positive), nine had postphlebitic syndrome, and one was normal. When positive SPG was combined with positive leg scan, the accuracy raised to 95.6% (44 of 46 legs). If the SPG was positive but the leg scan was negative, the possibility of postphlebitic syndrome was most likely (8 of 10, i.e., 80%).
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PMID:A combined study of the strain gauge plethysmography and I-125 fibrinogen leg scan in the differentiation of deep vein thrombosis and postphlebitic syndrome. 649 79

Postphlebitic syndrome occurs in 20 per cent of patients with deep vein thrombosis. Symptoms are nonspecific; they include heaviness, fatigue, pain, and vary from patient to patient. The signs of edema, skin pigmentation, dermatitis, varicosities, and ulceration are a result of the increased retrograde venous pressure secondary to the valve destruction by the phlebitic process. The aim of therapy is to improve venous support by graduated elastic stockings and to ensure good skin care and exercise.
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PMID:Postphlebitic syndrome. 653 97

The efficacy of heparin, sodium warfarin, and elastic stockings in preventing the late leg sequelae of deep venous thrombosis was evaluated by reexamining 15 patients with previous acute deep venous thrombosis so treated. All 5 patients with iliocommon femoral disease and only 5 of 10 patients with distal disease had evidence of postphlebitic syndrome. Venous Doppler and strain gauge plethysmography confirmed these clinical findings. The most striking and consistent laboratory abnormalities were in the patients with proximal disease. Treatment of acute deep venous thrombosis by traditional means does not prevent the clinical and laboratory late leg sequelae. In light of these findings, serious investigation of new therapeutic modalities is strongly suggested.
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PMID:Late sequelae of deep venous thrombosis. Diagnostic and therapeutic considerations. 669 94

Objective assessment of venous function based on venous refilling time recorded by photoplethysmography (PPG) was done in 89 patients with postphlebitic syndrome (47), primary varicose veins (29), and after an episode of acute deep vein thrombosis (13). Limbs with symptomatic postphlebitic changes had a shortened venous refilling time of 15.6 +/- 11 seconds (normal greater than 20 seconds). When venographic findings (ascending and descending) in 47 patients with postphlebitic syndrome were analyzed, it was noted that femoral valve incompetence demonstrated by descending venography was a common finding (81%), even in asymptomatic limbs (85%). Venous refilling time bore no relationship to the degree of femoral venous valve reflux. However, if there were associated diseased deep veins with incompetent perforating veins, the venous refilling time was much shorter (14 +/- 4 seconds) than in limbs without calf perforating veins (27 +/- 11.9 seconds, P less than 0.05). A tourniquet was used to impede saphenous flow, and changes in refilling time were recorded in 34 limbs with varicosities of the long saphenous vein. Refilling time normalized after tourniquet application in 31 limbs (14.43 +/- 4.34 to 30.64 +/- 11.9 seconds), and all patients underwent vein stripping. Postoperative recording confirmed the improvement in venous refilling time (29.52 +/- 27.8 seconds, P less than 0.05). Thirteen patients with acute deep vein thrombosis had serial PPG tests during a follow-up period of 27 months (mean 15.8 months). Seven had initial abnormal PPG results and persistently abnormal readings, and all developed postphlebitic changes. Venous refilling time is an useful test to determine the hemodynamic significance of femoral venous valve incompetence and to assess the effect of vein stripping on varicose veins. In acute deep vein thrombosis, follow-up study may help to identify patients at risk for development of postphlebitic changes.
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PMID:Hemodynamic assessment of venous problems. 684 79

Iliac vein thrombosis is an uncommon type of deep vein thrombosis (DVT) that occurs in young patients following surgical procedures for scoliosis. The symptomatology is diffuse and this type of DVT carries a risk for fatal pulmonary embolism as well as the development of a postphlebitic syndrome. Combined radionuclide phlebography and lung scanning were performed in 16 patients operated on for scoliosis with the Harrington procedure. In three patients with diffuse pain in the inguinal region, iliac vein thrombosis was easily visualized in the radionuclide phlebogram and confirmed by conventional phlebography in two cases. Six patients without lung symptoms had perfusion defects typical for pulmonary embolism. It is concluded that radionuclide phlebography can be recommended as a diagnostic procedure for iliac vein thrombosis in patients with diffuse symptoms in the inguinal region or the lower abdomen after scoliosis surgery. Advantages include the ease of performance, good patient acceptance and low radiation dose compared with conventional phlebography. Asymptomatic pulmonary embolism as diagnosed by the perfusion lung scan was an unexpected finding which raised clinical considerations that require further investigations.
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PMID:Combined radionuclide phlebography and lung scanning in patients operated on for scoliosis with the Harrington procedure. 743 9


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