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Management of Post-thrombotic Syndrome: A Comprehensive Review.
Current Pharmaceutical Design ( IF 3.1 ) Pub Date : 2022-01-01 , DOI: 10.2174/1381612828666220131094655
Nikolaos Chaitidis 1 , Damianos G Kokkinidis 2 , Zoi Papadopoulou 3 , Natasha Hasemaki 4 , Robert Attaran 2 , Christos Bakoyiannis 4
Affiliation  

BACKGROUND Post-thrombotic syndrome (PTS) is the most common long-term complication of acute deep venous thrombosis (DVT). The cumulative incidence of PTS in the first two years after the first acute DVT diagnosis approximates 25%. OBJECTIVE This study aims to summarize the most recent updates and provide a comprehensive review of the current management of PTS. METHODS We searched MEDLINE/PMC/NCBI Bookshelf (PubMed), Cochrane, Embase, Scopus, ClinicalTrials, and OpenGrey databases for relevant articles in English published from the establishment of each separate database until February 9, 2021. CONCLUSION PTS constitutes the most frequent long-term complication of lower limb deep venous thrombosis (DVT). Lifestyle changes and compression treatment represent an integral part of PTS management and have a clear benefit to offer in PTS patients. Pharmacological treatment with phlebotonic and non-phlebotonic medications, such as micronized purified flavonoid fraction (MMPF) and sulodexide, respectively, may have a more central and significant role in PTS management than previously thought. The introduction of percutaneous transluminal venoplasty (PTV) and stenting has again raised our expectations with the field, along with new concerns and considerations. There is a growing number of studies that report promising results on patientoriented outcomes on PTS patients who were treated with PTV and stenting. Moreover, hybrid (endovascular/ surgical) interventions may also represent a safe and efficacious treatment option for a subset of patients with PTS. Patient selection criteria for endovascular and hybrid interventional treatment should be carefully set and standardized. Post-operative care after venoplasty is an important field of future research with potential clinical impact. Management of deep and superficial reflux remains controversial. Hopefully, future prospective studies shall provide more robust evidence on the management of PTS.

中文翻译:

血栓后综合征的管理:综合评价。

背景血栓形成后综合征(PTS)是急性深静脉血栓形成(DVT)最常见的长期并发症。在第一次急性 DVT 诊断后的前两年,PTS 的累积发生率约为 25%。目的 本研究旨在总结最新的更新,并提供对当前 PTS 管理的全面回顾。方下肢深静脉血栓形成(DVT)的长期并发症。生活方式的改变和加压治疗是 PTS 管理的一个组成部分,对 PTS 患者有明显的好处。静脉注射和非静脉注射药物的药理学治疗,例如微粉化纯化黄酮组分 (MMPF) 和舒洛地特,在 PTS 管理中可能比以前认为的更重要和更重要。经皮腔内静脉成形术 (PTV) 和支架置入术的引入再次提高了我们对该领域的期望,以及新的担忧和考虑。越来越多的研究报告了接受 PTV 和支架治疗的 PTS 患者以患者为导向的结果的可喜结果。此外,混合(血管内/手术)干预也可能代表部分 PTS 患者的安全有效的治疗选择。应仔细制定和标准化血管内和混合介入治疗的患者选择标准。静脉成形术后的术后护理是未来研究的一个重要领域,具有潜在的临床影响。深部和浅表反流的处理仍存在争议。希望未来的前瞻性研究能够为 PTS 的管理提供更强有力的证据。
更新日期:2022-01-31
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