DEEP VENOUS THROMBOSIS - A PROSPECTIVE 3-MONTH FOLLOW-UP USING DUPLEXSCANNING AND STRAIN-GAUGE PLETHYSMOGRAPHY

1. The purpose of the study was to evaluate the degree of thrombus reg ression, development of valvular insufficiency, impaired calf muscle p ump function and clinical symptoms after a period of acute deep venous thrombosis, 2. Seventy patients with acute deep venous thrombosis, di agnosed by duplex scanning or venography, received treatment with hepa rin and oral coumarin derivatives according to a standard protocol. AU patients wore graduated compression stockings during the whole study period, Duplex scanning was performed at diagnosis and 1 and 3 months later to measure thrombus mass and reflux. The supine venous pump func tion test was used to assess calf muscle pump function. 3. Three month s follow-up was completed in 60 patients. In total 218 (28%) out of 78 0 vein segments were initially thrombosed and 134 (17%) could not be t raced. A statistically significant reduction of thrombus mass was reco rded throughout the study period. Total resolution of thrombosis in al l vein segments occurred in 25% of the patients within 1 month and in 40% in 3 months, There was no difference in regression between the var ious proximal vein segments. Distal segments showed more regression th an proximal segments. Reflux occurred in 27% of the initially thrombos ed veins and in 15% of the patent veins. Patients who showed total res olution after 1 month had a significantly higher calf muscle pump func tion than patients without total resolution (70%(pf) vs 61%(pf), P < 0 .05), Patients with reflux in two or more segments had a significantly lower calf muscle pump function than patients with reflux in less tha n two segments (58%(pf) vs 69%(pf), P < 0.05), 4. Using duplex scannin g and the supine venous pump function test 3 months after an acute dee p venous thrombosis, overall haemodynamic abnormalities and local site of valve incompetence could readily be identified. Patients with haem odynamic abnormalities might be at risk to develop the post-thrombotic syndrome. There was no difference in thrombus regression between the various proximal vein segments. Reflux was significantly more often se en in initially thrombosed veins. Thirty-five percent of the patients developed an abnormal calf muscle pump function after 3 months. Patien ts with early resolution of thrombus had a higher calf muscle pump fun ction after 3 months.