DUPLEX ULTRASOUND IN THE HEMODYNAMIC EVALUATION OF THE LATE SEQUELAE OF DEEP VENOUS THROMBOSIS

Purpose: The use of duplex ultrasound scanning to evaluate the hemodyn amic outcome of deep venous thrombosis 7 to 13 years after the origina l diagnosis. Methods: Duplex ultrasound was used to re-examine 1212 se gments of vein from 72 patients (49 men, 23 women) with deep venous th rombosis previously diagnosed by means of phlebography to detect reflu x and obstruction and evaluate now; 611 segments were initially thromb osed and 601 segments were open. To define reflux, reversed now in 31 healthy persons was measured. Results: In a review of all veins of the 72 patients, 8 patients (11%) had completely normal duplex results in all veins, 33 (46%) had reflux, 6 (8%) had at least one noncompressib le vein, segment, and 25 (35%) had a combination of both. In the proxi mal vein segments without initial thrombosis a higher percentage was n ormal (73%) than in segments with initial thrombosis (46%). There was a significantly higher frequency of reflux (46%, p = 0.05) and noncomp ressibility (12%, p < 0.01) in initially thrombosed proximal vein segm ents than in vein segments without initial thrombosis (reflux 25%, non compressibility 3%). Distal to the knee 125 (17%) of 720 vein segments were not traceable. Significantly more initially thrombosed vein segm ents were not traceable (p < 0.01). In distal vein segments there was no significant difference in reflux (7% versus 5%) and noncompressibil ity (10% versus 5%) between vein segments with and without initial thr ombosis. flow was present in 99% of the 611 previously thrombosed prox imal and distal segments. Conclusions: Most patients with deep venous thrombosis still had venous abnormalities 7 to 13 years after the init ial diagnosis. The most common abnormality was reflux. Significantly m ore abnormalities were found in initially thrombosed segments. The abn ormalities were found in the proximal vein segments and in the distal vein segments, although less frequently in the latter.