Document Detail


Spontaneous recanalization in deep venous thrombosis: a prospective duplex ultrasound study.
MedLine Citation:
PMID:  17353889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The aim of this study was to evaluate the dynamics of the recanalization process (spontaneous fibrinolysis) in completely occlusive deep venous thrombosis (DVT) using duplex ultrasound examination and to investigate the influence of different factors on the evolution of thrombus regression. METHODS: This longitudinal prospective study was done with 74 consecutive patients with completely occlusive acute multilevel DVT, confirmed by echo duplex scan after 1, 3, 6, and 12 months. At each re-evaluation, the degree and the type of recanalization were determined. Efficacy of tinzaparin (175 IU/kg, s.c., q.d. for 7-14 days) and continued with warfarin (12 months at INR 2-3) as well as patients' compliance with compressive elastic hosiery wearing were carefully followed. Relationship between the degree and pattern of recanalization and patients' age, gender, as well as thrombosis etiology and location were determined. RESULTS: Sixty-four patients completed the study. The mean recanalization rate was 39.7% at 1, 64.8% at 3, 82% at 6, and 90.3% at 12 months. Marginal recanalization was more frequently observed, but recanalization pattern was changing during follow-up. CONCLUSIONS: In the case of efficient anticoagulant and compressive therapy, the spontaneous recanalization process of DVT is important from the very first month of evolution, but an almost complete re-permeabilization is observed only after 12 months of treatment. The unilocular, marginal pattern of thrombus lysis is often observed and has better evolution than the multilocular cavernous one. The dynamics of recanalization are characterized by distal-to-proximal extension and in the first 6 months are significantly influenced by patient's gender and thrombosis etiology.
Authors:
A Puskás; Z Balogh; L Hadadi; M Imre; E Orbán; K Kósa; Z Brassai; S A Mousa
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  International angiology : a journal of the International Union of Angiology     Volume:  26     ISSN:  0392-9590     ISO Abbreviation:  Int Angiol     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-13     Completed Date:  2007-07-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8402693     Medline TA:  Int Angiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  53-63     Citation Subset:  IM    
Affiliation:
Department of Angiology and Second Medical Clinic, University of Medicine and Pharmacy, Targu Mures, Romania.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anticoagulants / therapeutic use*
Female
Fibrinolysis / drug effects*
Fibrinolytic Agents / therapeutic use*
Follow-Up Studies
Heparin, Low-Molecular-Weight / therapeutic use
Humans
Male
Middle Aged
Patient Compliance
Prospective Studies
Sex Factors
Stockings, Compression*
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Color*
Venous Thrombosis / blood,  diagnosis*,  drug therapy,  etiology,  therapy*
Warfarin / therapeutic use
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 0/tinzaparin; 81-81-2/Warfarin

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