Post-trombophlebitic Syndrom Wunden

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Post-trombophlebitic Syndrom Wunden Post-trombophlebitic Syndrom Wunden

Post-trombophlebitic Syndrom Wunden

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- А как Патрик?

Post-trombophlebitic Syndrom Wunden

Post-thrombotic syndrome is the development of symptoms and signs of chronic venous insufficiency following deep vein thrombosis DVT and is an all too common, burdensome, and costly complication [ 1,2 ]. The term "post-thrombotic" replaces the post-trombophlebitic Syndrom Wunden terminology "postphlebitic" syndrome [ 3 ]. A combination of reflux due to valvular incompetence, and venous hypertension due to thrombotic obstruction, is thought to contribute to post-thrombotic syndrome [ 4,5 ].

Symptoms and signs of chronic venous insufficiency may include pain, vein dilation, edema, skin pigmentation, and venous ulcers. Our approach post-trombophlebitic Syndrom Wunden the diagnosis, treatment and prevention of post-thrombotic syndrome is in broad agreement with published guidelines from the American Heart Post-trombophlebitic Syndrom Wunden [ 6 ].

Prevention of DVT through prophylaxis, timely recognition and treatment of DVT, and prevention of recurrent DVT will continue to have the greatest impact on reducing the overall burden of post-thrombotic syndrome [ 7 ]. The treatment of lower extremity DVT is discussed separately. See "Overview of the post-trombophlebitic Syndrom Wunden of go here extremity deep vein thrombosis DVT ".

Post-thrombotic syndrome develops as a consequence of long-standing venous hypertension [ 7 ]. One study identified a high peak reflux velocity in the deep proximal veins as an independent predictor of post-thrombotic syndrome [ 8 ]. Increased venous pressures are transmitted to the capillary beds, promoting transudation of fluid and large molecules, resulting in tissue edema, subcutaneous fibrosis, and, finally, tissue hypoxia and ulceration [ ].

See "Pathophysiology of chronic venous disease". Acute DVT causes obstruction of venous outflow, which can be partial or complete. Increased levels of inflammatory cytokines or adhesion molecules, such as interleukin-6 and intercellular adhesion molecule-1 have also been linked with the development of post-thrombotic syndrome, suggesting that inflammation may play a role in the pathophysiology of post-thrombotic syndrome [ ].

The inflammatory response post-trombophlebitic Syndrom Wunden acute thrombosis and the process of recanalization directly damages venous valves. Reflux occurs early, progressively increasing from 17 percent of patients at one week to 69 percent of patients at one year following the diagnosis of DVT [ 15 ]. The degree of initial vein occlusion correlates with the likelihood of developing reflux [ 15 ].

Reflux in the more proximal lower extremity veins may be particularly important to the development of post-thrombotic syndrome. However, popliteal valve incompetence has also been found to increase the risk of post-thrombotic syndrome, particularly when combined with residual vein thrombosis [ 16,17 ].

Recanalization is a complex process involving intrinsic events within the thrombus, and is related to an increase in endogenous fibrinolysis [ 18,19 ]. An inverse relationship between levels of fibrinolytic inhibitors and the degree of recanalization has post-trombophlebitic Syndrom Wunden described [ 18 ]. Over time, the amount of thrombus decreases, and in some cases, the lumen reestablishes itself ie, recanalization.

More rapid resolution of thrombus may preserve valvular function [ ]. Recanalization can be seen as early as post-trombophlebitic Syndrom Wunden weeks from diagnosis [ 23,24 ], but about half of legs have Это Laservorrichtung Krampf успела thrombus causing partial obstruction [ go here ].

The rate of recanalization appears to be related to the initial thrombus load [ 25 ], and thrombus site with distal thrombi undergoing more rapid and complete resolution [ 26 ]. Subscribers log in here. UpToDate synthesizes the most recent medical information into evidence-based practical recommendations that healthcare professionals trust to make the right post-trombophlebitic Syndrom Wunden decisions. It seems to us that you have your JavaScript turned off on your browser. JavaScript is required in order for our site to behave correctly.

Please enable your JavaScript to continue post-trombophlebitic Syndrom Wunden our site. To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:. Resident, Fellow or Student.

Literature review current through: Http:// post-trombophlebitic Syndrom Wunden last updated: The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment.

Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. UpToDate is the most trusted clinical decision support resource in the world. Learn how UpToDate can help you. Post-thrombotic syndrome Chronic venous disease Deep vein thrombosis Graduated compression stockings Thrombophlebitis Venous thromboembolism.

Post Thrombotic Syndrome

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