Underlying factors influencing the development of the post-thrombotic limb

Abstract

Purpose: This study was designed to determine whether patients having underlying venous disease in their contralateral limbs indicates a more severe long-term clinical outcome in the ipsilateral limb after a deep vein thrombosis (DVT) and to determine what other factors may influence the long-term outcome. Methods: An acute DVT was initially diagnosed by means of duplex ultrasound scanning. Follow-up clinical examinations and bilateral duplex reflux studies were performed for a mean period as long as 3 years. The patients were divided into two groups: group I, those with no history of a contralateral DVT, and group II, those with a history of a contralateral DVT. The patients were classified at their final examination according to the Clinical, Etiology, Anatomic, Pathophysiologic (CEAP) classification, and the ipsilateral and contralateral limbs were compared. Predisposing factors were compared with the final clinical outcome. Results: Sixty-three patients were monitored in a mean follow-up period of 3 years. There was a significant difference in the incidence of symptoms between the ipsilateral limbs (P < .01) and the contralateral limbs (P 3) had mild to moderate venous disease in their contralateral limb and had nonreversible risk factors. Conclusion: There are a significant number of patients with an acute DVT who had an underlying venous disease in the uninvolved contralateral limb. An ipsilateral post-thrombotic limb is more likely to develop in patients with primary venous reflux after an acute DVT. The level of venous dysfunction in the contralateral limb is an indication of the severity of disease developing in the ipsilateral limb. The initial risk factors of the patients have an influence on the final clinical outcome.