Definition of post-thrombotic syndrome following lower extremity deep venous thrombosis and standardization of outcome measurement in pediatric clinical investigations

摘要

Post-thrombotic syndrome (PTS) is a syndrome of chronic venous insufficiency following deep venous thrombosis (DVT) that affects children as well as adults. PTS may be characterized by physical signs in an affected limb such as edema, dilated superficial collateral veins, stasis dermatitis and/or ulceration, and functional consequences such as limitation in activities due to associated pain. The pathophysiology of PTS involves venous hypertension [1], which may result from persistent thrombotic veno-occlusion, venous valvular reflux due to damage from previous thrombosis, or other causes of impaired venous return. Additionally, inflammation may contribute to venous valvular damage [2]. The estimated frequency of PTS following upper/lower extremity DVT in children is 26%, based on a systematic review involving approximately 20 eligible studies and nearly 1000 patients [3].