Prevention and treatment of postphlebitic syndrome
: results of a 3-part study.
Surgical thrombectomy cannot open the small venules that are affected in venous gangrene, and it does not prevent valvular incompetence or postphlebitic syndrome
. The incidence of postphlebitic syndrome
may be as high as 94% among survivors.
We performed a computerized search of the literature (PubMed, EMBASE, Medline through PubMed, SCOPUS and Web of Science) from 1990 up to December 2012, using the search terms lupus coagulation inhibitor, lupus anticoagulant, antiphospholipid, factor VIII, antithrombin deficiency, protein S, protein C, prothrombin G20210A, factor V Leiden, thrombophilia, venous ulcers, postphlebitic syndrome, post-thrombotic syndrome, venous stasis syndrome.
Julian et al., "Prevention and treatment of postphlebitic syndrome: results of a 3-part study," Archives of Internal Medicine, vol.161, no.17, pp.2105-2109, 2001.
Following the surgery, she suffered massive bleeding and deep-vein thrombosis, resulting in permanent postphlebitic syndrome
in her left leg.
The clinical complications from VTE--which is manifested as either deep-vein thrombosis (DVT) or pulmonary embolism (PE)--include death from PE, postphlebitic syndrome
, and recurrent VTE.
The clinical complications from VTE-which is manifested as either deep-vein thrombosis (DVT) or pulmonary embolism (PE)--include death from PE, postphlebitic syndrome
, and recurrent VTE.
DOCTOR'S DEFENSE: The patient didn't wear compression stockings to prevent blood clots but because of swelling from a long history of postphlebitic syndrome
. The foot and back complaints were similar to previous complaints related to the patient's postphlebitic syndrome
and degenerative disc disease.
Oral anticoagulation with warfarin decreases the incidence of recurrent thromboembolic events, while the extended use of compression stockings decreases the development of the postphlebitic syndrome.
The development of mild-moderate postphlebitic syndrome was decreased by 58% (ARR=27.1%; NNT=3.7), and the incidence of severe postphlebitic syndrome was decreased by 51% (ARR=12%; NNT=8.3).