Serveur d'exploration sur le lymphœdème

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Advances in the surgical treatment of postthrombotic syndrome

Identifieur interne : 000483 ( PascalFrancis/Checkpoint ); précédent : 000482; suivant : 000484

Advances in the surgical treatment of postthrombotic syndrome

Auteurs : Alessandra Puggioni [États-Unis] ; Fedor Lurie [États-Unis]

Source :

RBID : Pascal:08-0028054

Descripteurs français

English descriptors

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.


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Pascal:08-0028054

Le document en format XML

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<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>
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<s0>Vaso sanguíneo patología</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Pathologie des veines</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Venous disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Vena patología</s0>
<s5>40</s5>
</fC07>
<fN21>
<s1>052</s1>
</fN21>
</pA>
</standard>
</inist>
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<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>
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