Advances in the surgical treatment of postthrombotic syndrome
Identifieur interne : 007762 ( Main/Exploration ); précédent : 007761; suivant : 007763Advances in the surgical treatment of postthrombotic syndrome
Auteurs : Alessandra Puggioni [États-Unis] ; Fedor Lurie [États-Unis]Source :
- Phlebolymphology [ 1286-0107 ] ; 2007.
Descripteurs français
- Pascal (Inist)
- Lymphoedème, Varice, Thrombose profonde, Maladie chronique, Syndrome d'apnée du sommeil, Syndrome postthrombotique veineux, Chirurgie, Traitement, Technique, Etude cas, Ulcère, Mortalité, Complication, Incidence, Obstruction, Stade avancé, Homme, Voie endovasculaire, Diagnostic, Dérivation, Système autologue, Italien, Valvule veine, Voie percutanée.
- Wicri :
- topic : Maladie chronique, Chirurgie, Mortalité, Homme.
English descriptors
- KwdEn :
- Advanced stage, Autologous system, Bypass, Case study, Chronic disease, Complication, Deep vein thrombosis, Diagnosis, Endovascular route, Human, Incidence, Italian, Lymphedema, Mortality, Obstruction, Percutaneous route, Postphlebitic syndrome, Sleep apnea syndrome, Surgery, Technique, Treatment, Ulcer, Varix, Vein valve.
Abstract
Postthrombotic syndrome (PTS) is the late complication of lower extremitiy deep venous thrombosis (DVT). Its incidence is approximately 3/1000 per year in the adult population. A combination of reflux and obstruction is often seen in limbs with more advanced clinical disease than obstruction alone. A thorough workup of the patient with disabling PTS is necessary to identify patients amenable to open surgical or endovascular intervention. Duplex scanning is the gold standard for diagnosis of chronic venous disease. The superficial system should be addressed first, followed by or in conjunction with the perforator and deep systems. Chronically obstructed veins are amenable to endovascular interventions, sometimes in combination with disobliteration of the veins ("endophlebectomy"), bypasses or valvular repair. A novel autologous valve reconstruction (the Italian neo-valve) that involves the construction of a valve in postthrombotic veins by using an intimal flap has been performed with satisfactory results. A percutaneously-implantable, non-immunogenic venous valve that remains patent and competent is an attractive alternative to deep venous reconstructions. Results from animal studies with a bioprosthetic valve (the Portland valve) are encouraging.
Affiliations:
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Burns School of Medicine, University of Hawaii</s1><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Department of Surgery, John A. 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Burns School of Medicine, University of Hawaii</s1><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Department of Surgery, John A. Burns School of Medicine, University of Hawaii</wicri:noRegion></affiliation></author><author><name sortKey="Lurie, Fedor" sort="Lurie, Fedor" uniqKey="Lurie F" first="Fedor" last="Lurie">Fedor Lurie</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Surgery, John A. Burns School of Medicine, University of Hawaii</s1><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Department of Surgery, John A. Burns School of Medicine, University of Hawaii</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Phlebolymphology</title><idno type="ISSN">1286-0107</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Phlebolymphology</title><idno type="ISSN">1286-0107</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Advanced stage</term><term>Autologous system</term><term>Bypass</term><term>Case study</term><term>Chronic disease</term><term>Complication</term><term>Deep vein thrombosis</term><term>Diagnosis</term><term>Endovascular route</term><term>Human</term><term>Incidence</term><term>Italian</term><term>Lymphedema</term><term>Mortality</term><term>Obstruction</term><term>Percutaneous route</term><term>Postphlebitic syndrome</term><term>Sleep apnea syndrome</term><term>Surgery</term><term>Technique</term><term>Treatment</term><term>Ulcer</term><term>Varix</term><term>Vein valve</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphoedème</term><term>Varice</term><term>Thrombose profonde</term><term>Maladie chronique</term><term>Syndrome d'apnée du sommeil</term><term>Syndrome postthrombotique veineux</term><term>Chirurgie</term><term>Traitement</term><term>Technique</term><term>Etude cas</term><term>Ulcère</term><term>Mortalité</term><term>Complication</term><term>Incidence</term><term>Obstruction</term><term>Stade avancé</term><term>Homme</term><term>Voie endovasculaire</term><term>Diagnostic</term><term>Dérivation</term><term>Système autologue</term><term>Italien</term><term>Valvule veine</term><term>Voie percutanée</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Maladie chronique</term><term>Chirurgie</term><term>Mortalité</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Postthrombotic syndrome (PTS) is the late complication of lower extremitiy deep venous thrombosis (DVT). Its incidence is approximately 3/1000 per year in the adult population. A combination of reflux and obstruction is often seen in limbs with more advanced clinical disease than obstruction alone. A thorough workup of the patient with disabling PTS is necessary to identify patients amenable to open surgical or endovascular intervention. Duplex scanning is the gold standard for diagnosis of chronic venous disease. The superficial system should be addressed first, followed by or in conjunction with the perforator and deep systems. Chronically obstructed veins are amenable to endovascular interventions, sometimes in combination with disobliteration of the veins ("endophlebectomy"), bypasses or valvular repair. A novel autologous valve reconstruction (the Italian neo-valve) that involves the construction of a valve in postthrombotic veins by using an intimal flap has been performed with satisfactory results. A percutaneously-implantable, non-immunogenic venous valve that remains patent and competent is an attractive alternative to deep venous reconstructions. Results from animal studies with a bioprosthetic valve (the Portland valve) are encouraging.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Puggioni, Alessandra" sort="Puggioni, Alessandra" uniqKey="Puggioni A" first="Alessandra" last="Puggioni">Alessandra Puggioni</name></noRegion><name sortKey="Lurie, Fedor" sort="Lurie, Fedor" uniqKey="Lurie F" first="Fedor" last="Lurie">Fedor Lurie</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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