Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/jvb.2013.050
Jornal Vascular Brasileiro
Review Article

Recanalization after acute deep vein thrombosis

Recanalizacao apos trombose venosa profunda aguda

Gustavo Mucoucah Sampaio Brandao; Marcone Lima Sobreira; Hamilton Almeida Rollo

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Abstract

The process of recanalization of the veins of the lower limbs after an episode of acute deep venous thrombosis is part of the natural evolution of the remodeling of the venous thrombus in patients on anticoagulation with heparin and vitamin K inhibitors. This remodeling involves the complex process of adhesion of thrombus to the wall of the vein, the inflammatory response of the vessel wall leading to organization and subsequent contraction of the thrombus, neovascularization and spontaneous lysis of areas within the thrombus. The occurrence of spontaneous arterial flow in recanalized thrombosed veins has been described as secondary to neovascularization and is characterized by the development of flow patterns characteristic of arteriovenous fistulae that can be identified by color duplex scanning. In this review, we discuss some controversial aspects of the natural history of deep vein thrombosis to provide a better understanding of its course and its impact on venous disease.

Keywords

venous thrombosis, ultrasonography Doppler color, review literature as topic

Resumo

O processo de recanalização das veias dos membros inferiores, após um episódio de trombose venosa profunda aguda em pacientes anticoagulados com heparina e inibidores da vitamina K, faz parte da evolução natural da remodelagem do trombo venoso. Esse complexo processo de remodelagem envolve a adesão do trombo à parede da veia, à resposta inflamatória da parede do vaso, levando à organização e subsequente contração do trombo, à neovascularização e à lise espontânea de áreas no interior do trombo. A presença de fluxo arterial espontâneo em veias com trombose recanalizada tem sido descrita como secundária à neovascularização e se caracteriza pelo desenvolvimento de fluxo com padrão de fístulas arteriovenosas, identificadas por meio de mapeamento dúplex colorido. Nesta revisão, são discutidos alguns aspectos controversos da história natural da trombose venosa profunda, para uma melhor compreensão da sua evolução e do seu impacto sobre a doença venosa.

Palavras-chave

trombose venosa, ultrassonografia Doppler em cores, literatura de revisao como assunto

References

Maffei FHA, Rollo HA. Trombose venosa profunda dos membros inferiores: incidência, patogenia, patologia, fisiopatologia e diagnóstico. Doenças Vasculares Periféricas. :1557-578.

Caggiati A, Bergan JJ, Gloviczki P, Jantet G, Wendell-Smith CP, Partsch H. Nomenclature of the veins of the lower limbs: an international interdisciplinary consensus statement. J Vasc Surg.. ;36(2):416-22.

Caggiati A, Bergan JJ, Gloviczki P, Eklof B, Allegra C, Partsch H. Nomenclature of the veins of the lower limb: extensions, refinements, and clinical application. J Vasc Surg.. ;41(4):719 24-719 24.

Lastoria S, Sobreira M L. Tromboflebite superficial. Doenças Vasculares Periféricas. :1547-556.

Sobreira ML, Maffei FH, Yoshida WB. Prevalence of deep vein thrombosis and pulmonary embolism in superficial thrombophlebitis of the lower limbs: prospective study of 60 cases. Int Angiol.. ;28(5):400-08.

Susan R, Kahn SR. The post-thrombotic syndrome: the forgotten morbidity of deep venous thrombosis. J Thromb Thrombolysis.. ;21(1):41-8.

Tófano VAC. Avaliação clínica e ultrassonográfica tardia de pacientes com trombose venosa prounda, portadores de trombofilia. :169-69.

Matida CK. Trombose venosa profunda dos membros inferiores em crianças e adolecentes tratados em um único centro no Brasil: epidemiologia e evolução. :91-1.

Fowkes FJ, Price JF, Fowkes FG. Incidence of diagnosed deep vein thrombosis in the general population: systematic review. Eur J Vasc Endovasc Surg.. ;25(1):1-5.

Naess IA, Christiansen SC, Romundstad P, Cannegieter SC, Rosendaal FR, Hammerstrom J. Incidence and mortality of venous thrombosis: a population-based study. J Thromb Haemost.. ;5(4):692-99.

Hasson PO, Welin L, Tibblin G, Eriksson H. Deep vein thrombosis and pulmonary embolism in the general population. The study of men born in 1913. Arch Int Med.. ;157:1665-670.

White RH, Zhou H, Romano PS. Incidence of idiopathic deep venous thrombosis and secundary thromboembolism among ethnic groups in California. Ann Int Med.. ;128:737-40.

Nordström M, Lindblad B, Bergqvist D, Kjellström T. A prospective study of the incidence of deep vein thrombosis within a defined urban population. J Int Med.. ;232:155-260.

Incidence of venous thromboembolism: A community-based in Western France. Thromb Haemost.. ;83:657-60.

Hull R, Hirsh J, Sackett DL. Clinical validity of a negative venogram in patients with clinically suspected venous thrombosis. Circulation.. ;64(3):622-25.

Strandness DE Jr. History of ultrasonic duplex scanning. Cardiovasc Surg.. ;4(3):273-80.

Wells PS, Anderson DR, Rodger M. Evaluation of D dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med.. ;349:1227-235.

Goodacre S, Sutton AJ, Sampson FC. Meta-analysis: The value of clinical assessment in the diagnosis of deep venous thrombosis. Ann Intern Med.. ;143(2):129-39.

Bernardi E, Prandoni P, Lensing AW. D-dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study. The Multicentre Italian D-dimer Ultrasound Study Investigators Group. BMJ.. ;317(7165):1037-040.

Guyatt GH, Akl EA, Crowther M, Gutterman DD. therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. ;141(2^sSuppl):7S-47S.

Watson LI, Armon MP. Thrombolysis for acute deep vein thrombosis. Cochrane Database Syst Rev. :CD002783-CD002783.

Vedantham S. The Attract Study (Acute Venous Thrombosis: Thrombus removal with adjunctive catheter-directed thrombolysis). .

Van B, Van Bemmelen PS, Hoeneveld H, Faber JA, Eikelboom BC. Thrombus regression in deep venous thrombosis.Quantification of spontaneous thrombolysis with duplex scanning. Circulation. ;86(2):414-19.

Krupski WC, Bass A, Dilley RB, Bernstein EF, Otis SM. Propagation of deep venous thrombosis identified by duplex ultrasonography. J Vasc Surg.. ;12(4):467-74.

Ashrani AA, Heit JA. Incidence and cost burden of post-thrombotic syndrome. J Thromb Thrombolysis.. ;28(4):465-76.

Ramacciotti E, Gomes M, De Aguiar ET. A cost analysis of the treatment of patients with post-thrombotic syndrome in Brazil. Thromb Res.. ;118(6):699-704.

Kahn SR, Ginsberg JS. Relationship between deep venous thrombosis and the postthrombotic syndrome. Arch Intern Med.. ;164(1):17-26.

Sevitt S. The vascularisation of deep-vein thrombi and their fibrous residue: a post mortem angio-graphic study. J Pathol.. ;111(1):1-11.

Sevitt S. The mechanisms of canalisation in deep vein thrombosis. J Pathol.. ;110(2):153-65.

Wakefield TW, Linn MJ, Henke PK. Neovascularization during venous thrombosis organization: a preliminary study. J Vasc Surg.. ;30(5):885-92.

Labropoulos N, Kang SS, Mansour MA, Giannoukas AD, Moutzouros V, Baker WH. Early thrombus remodelling of isolated calf deep vein thrombosis. Eur J Vasc Endovasc Surg.. ;23(4):344-48.

Labropoulos N, Bhatti AF, Amaral S. Neovascularization in acute venous thrombosis. J Vasc Surg.. ;42(3):515-18.

Barros F, Pontes S, Silva W, Prezzote B, Sandri J. Identificação pelo eco-doppler de fístula arteriovenosa na trombose venosa profunda. J Vasc Bras.. ;5(3):224-28.

Bergvall U, Hjelmstedt A. Recanalisation of deep venous thrombosis of the lower leg and thigh. A phlebographic study of fracture cases. Acta Chir Scand.. ;134(3):219-28.

Killewich LA, Macko RF, Cox K. Regression of proximal deep venous thrombosis is associated with fibrinolytic enhancement. J Vasc Surg.. ;26(5):861-68.

Porter JM, Moneta GL. Reporting standards in venous disease: An update. J Vasc Surg.. ;21:635-45.

Prandoni P, Cogo A, Bernardi E. A simple ultrasound approach for detection of recurrent proximal-vein thrombosis. Circulation.. ;88:1730-735.

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