Venous Insufficiency 4 Years after an Episode of Deep Vein Thrombosis: A Clinical and Plethysmographic Investigation

Abstract

Objective:

To evaluate the frequency of venous insufficiency following deep vein thrombosis (DVT).

Design:

Follow-up 4 years after a verified DVT.

Setting:

University hospital in Malmö.

Patients:

Eighty-seven subjects with venographically verified DVT.

Main outcome measure:

To compare venous function in legs, with and without previous DVT, by venous straingauge plethysmography and its correlation with clinical symptoms and signs.

Results:

Fifty-two per cent of patients described general discomfort from the thrombotic leg at follow-up. Active leg ulcers were found in three patients (3%); there were no signs of venous insufficiency in 33% at clinical examination. Thirty-seven patients (75%) with ≥ 1 cm difference in calf circumference between the thrombotic and contralateral leg had suffered a proximal DVT. The refilling time T₉₀ was pathological in 67% and the muscle pump function (RV) in 55%. In the nonthrombotic leg the corresponding figures were 53% and 40%. Nevertheless a positive correlation was found between RV of the thrombotic leg and the contralateral leg (r = 0.33) but an even stronger correlation was found for T₉₀ (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 process.