Deep venous thrombosis after surgery for Achilles tendon rupture: a provoked transient event with minor long-term sequelae

作者：Persson L M^*; Lapidus L J; Larfars G; Rosfors S

来源：Journal of Thrombosis and Haemostasis, 2011, 9(8): 1493-1499.

DOI：10.1111/j.1538-7836.2011.04376.x

• color duplex ultrasonography
• non-invasive venous examination
• postoperative deep venous thrombosis
• post-thrombotic syndrome
• venous plethysmography

Background: Deep venous thrombosis (DVT) occurs frequently in patients undergoing orthopedic surgery, but there is a lack of knowledge regarding long-term sequelae of DVT after different types of surgical procedures. Objective: To describe the long-term effect of symptomatic (SDVT) and asymptomatic (ADVT) deep venous thrombosis on venous function and subsequent incidence of post-thrombotic syndrome (PTS) in patients who have undergone surgery for Achilles tendon rupture. Patients/methods: This observational follow-up study includes 83 patients with postoperative DVT, examined after a mean of 7 years. There were two series of patients: 45 with SDVT and 38 with ADVT. In both series, more than 90% of the DVTs were limited to calf veins. Followup examinations comprised color duplex ultrasonography (CDU), strain-gauge plethysmography (SGP), clinical examination including scoring for venous disease and questionnaires for quality of life (QOL). Results: A mild degree of PTS was found in 11% of the patients: 13% in SDVT and 8% in ADVT patients. The rate of recurrent ipsilateral DVT was 2%. Deep venous reflux was more common in patients with SDVT than in ADVT patients (84% vs. 55%, P < 0.01). Only a few patients had plethysmograpically abnormal findings without difference between the two groups. Conclusion: DVT after surgery for Achilles tendon rupture consists mainly of distal DVTs and are associated with a low risk for PTS. Deep venous reflux was more common in SDVT than in ADVT patients, probably as an effect of larger DVTs in the former group.

• 出版日期2011-8