Surgical Options in Post-Thrombotic Syndrome

Abstract

Objective: To review the outcome of surgical restoration of deep vein competence in 53 patients with post-thrombotic syndrome. Design: Single patient group. Setting: Unite de Pathologie Vasculaire Jean Kunlin, Clinique du Grand-Large, av. Leon-Blum, Decines Charpieu, France. Patients: Fifty-three patients with clinical and radiological evidence of post-thrombotic syndrome uncontrolled by conventional conservative treatment. Interventions: Surgical restoration of deep vein competence by one of four methods: valvuloplasty, vein transplantation, vein transposition, or Psathakis' sling procedure. Main outcome measures: Sustained ulcer healing, photoplethysmography (PPG) refilling times, abolition of venous reflux on duplex scanning, symptomatic improvement. Results: All four techniques led to sustained ulcer healing in approximately two-thirds of patients. There was a poor correlation between maintenance of ulcer healing and improvement in PPG refilling times or abolition of reflux on duplex ultrasound.