VENOUS INSUFFICIENCY 4 YEARS AFTER AN EPISODE OF DEEP-VEIN THROMBOSIS- A CLINICAL AND PLETHYSMOGRAPHIC INVESTIGATION

Objective: To evaluate the frequency of venous insufficiency following deep vein thrombosis (DVT). Design: Follow-up 4 years after a verifie d DVT. Setting: University hospital in Malmo. Patients: Eighty-seven s ubjects with venographically verified DVT. Main outcome measure: To co mpare venous function in legs, with and without previous DVT, by venou s strain-gauge plethysmography and its correlation with clinical sympt oms and signs. Results: Fifty-two per cent of patients described gener al discomfort from the thrombotic leg at follow-up. Active leg ulcers were found in three patients (3%); there were no signs of venous insuf ficiency in 33% at clinical examination. Thirty-seven patients (75%) w ith greater than or equal to 1 cm difference in calf circumference bet ween the thrombotic and contralateral leg had suffered a proximal DVT. The refilling time T-90 was pathological in 67% and the muscle pump f unction (RV) in 55%. In the nonthrombotic leg the corresponding figure s were 53% and 40%. Nevertheless a positive correlation was found betw een RV of the thrombotic leg and the contralateral leg (r = 0.33) but an even stronger correlation was found for T-90 (r = 0.74). Conclusion : Venous insufficiency was found in 60% of legs 4 years after DVT but was also found in 14% of legs without previous thrombosis. This may be caused not only by effects of the thrombosis but also by the ageing p rocess.