Ultrasound analysis of venous remodeling in post-thrombotic syndrome

Post-thrombotic syndrome (PTS) is a frequent chronic complication of deep vein thrombosis (DVT) (20% to 50%). It can be disabling (5% to 10%) with an impact on quality of life and healthcare costs. PTS treatments are limited and prevention is crucial. Recognition of ultrasound criteria for predicting the onset of PTS would promote early treatment. Reflux and venous obstruction, which lead to venous hypertension, must be investigated by duplex ultrasound when following a DVT. The thrombus may remain occlusive, disappear, have partially or completely embolized. Although these sequelae are not correlated with the stage of venous insufficiency, they represent a recognized factor of DVT recurrence. The vein wall thickness could be an interesting parameter to analyze by ultrasound. It is a direct indicator of the post-inflammatory remodeling linked to the thrombus, however its clinical importance remains to be demonstrated by studies.