Objective

Deep vein thrombosis of the lower limbs is a common disease in vascular surgery. Approximately 20–50% of deep vein thrombosis patients develop post-thrombotic syndrome, which can severely affect the patient's quality of life. However, the precise science of the pathophysiology of the progression of the post-thrombotic syndrome remains unclear. Studies have demonstrated that patients with post-thrombotic syndrome of the lower limbs have impaired arterial wall endothelial function. Nevertheless, there is little research on the different impacts of post-thrombotic syndrome on the arterial wall endothelial function between the affected limbs and the healthy limbs. This study aims to assess this difference.

Methods

A total of 60 patients treated for the post-thrombotic syndrome of the lower limbs were included. The flow-mediated dilation (FMD%) and nitroglycerin-mediated dilation (NMD%) were measured to assess the different endothelial function alterations of the common femoral arterial wall between the affected limb and the healthy limb.

Results

No significant differences in the common femoral artery diameter between the affected limbs and the healthy limbs were discovered (8.94 ± 0.92 mm vs 8.75 ± 1.0 mm, P = 0.710). The flow-mediated dilation of the common femoral artery of the affected limbs were significantly lower compared to the healthy limbs (FMD%: 3.21 ± 1.07% vs 5.19 ± 1.35%, P = 0.001). However, there was no significant difference in the nitroglycerin-mediated dilation of the common femoral artery between the affected limbs and the healthy limbs（ NMD%: 13.37 ± 1.78% versus 14.45 ± 2.14%, P = 0.083).

Conclusions

Our results demonstrated the association between post-thrombotic syndrome and deteriorated endothelial functional properties of the arterial wall of the lower limbs. Endothelial dysfunction of the arteries wall was more severe in the affected lower limbs with the post-thrombotic syndrome than in the healthy limbs. The mentioned findings may partly explain the pathophysiology of the progression post-thrombotic syndrome of the lower limbs.

Highlights

tudies have demonstrated that patients with post-thrombotic syndrome of the lower limbs have impaired arterial wall endothelial function. Our results demonstrated the endothelial dysfunction of the arteries wall was more severe in the affected lower limbs with the post-thrombotic syndrome than in the healthy limbs. Our findings may partly explain the pathophysiology of the progression post-thrombotic syndrome of the lower limbs.

中文翻译：

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血栓后综合征对下肢动脉壁的影响

客观的

下肢深静脉血栓形成是血管外科的常见病。大约 20-50% 的深静脉血栓形成患者会出现血栓后综合征，这会严重影响患者的生活质量。然而，血栓形成后综合征进展的病理生理学的精确科学仍不清楚。研究表明，下肢血栓后综合征患者的动脉壁内皮功能受损。然而，关于血栓后综合征对患肢和健康肢体之间动脉壁内皮功能的不同影响的研究很少。本研究旨在评估这种差异。

方法

共纳入 60 名因下肢血栓形成后综合征接受治疗的患者。测量流动介导的扩张 (FMD%) 和硝酸甘油介导的扩张 (NMD%) 以评估受影响肢体和健康肢体之间股骨总动脉壁的不同内皮功能改变。

结果

未发现受影响肢体和健康肢体之间的股总动脉直径存在显着差异（8.94 ± 0.92 mm vs 8.75 ± 1.0 mm，P = 0.710）。与健康肢体相比，患肢股总动脉的血流介导扩张显着降低（FMD%：3.21 ± 1.07% vs 5.19 ± 1.35%，P = 0.001）。但患肢与健肢在硝酸甘油介导的股总动脉扩张方面无显着差异（NMD%：13.37 ± 1.78% vs 14.45 ± 2.14%，P = 0.083）。

结论

我们的研究结果证明了血栓形成后综合征与下肢动脉壁内皮功能特性恶化之间的关联。血栓后综合征患肢的动脉壁内皮功能障碍比健康肢体更严重。上述发现可能部分解释了下肢血栓形成后综合征进展的病理生理学。

强调

研究表明，下肢血栓形成后综合征患者的动脉壁内皮功能受损。我们的研究结果表明，血栓形成后综合征患者下肢动脉壁的内皮功能障碍比健康肢体更严重。我们的研究结果可能部分解释了下肢血栓形成后综合征进展的病理生理学。