Development of postthrombotic syndrome after acute unilateral iliofemoral thrombosis: Clinical dynamics and hemodynamic changes

Four hundred thirty-six patients with acute unilateral thrombosis in the il iofemoral venous segment were followed up to establish the relationship bet ween changes in the veins and clinical dynamics of postthrombotic syndrome. Physical examination and ascending phlebography were performed at the time of admission and 1 month later. Follow-up visits (physical examination and venous ultrasound study) were performed annually during 10 years. Cumulati ve rate of class 0 extremities decreased from 89% at the first year to 59% after 10 years. Progressive dynamics was seen in 41% of cases; 17% of these extremities had occlusions, and 83% had proximal reflux; 59% of the extrem ities demonstrated stable-type clinical dynamics. Occlusions were found in 41% and reflux in 59% of these cases. Recanalization and valvular incompete nce at the site of the initial deep vein thrombosis are more likely to lead to progressive type of the disease. Valvular incompetence in the distal ve ins does not correlate with severity of the disease.