L’analyse échographique du remodelage veineux dans le syndrome post-thrombotique /.Ultrasound analysis of venous remodeling in post-thrombotic syndrome
Seance of wednesday 11 january 2023 (Actualités sur la maladie veineuse post thrombotique)
DOI number : 10.26299/e2y1-mz76/emem.2023.1.03
Abstract
Le syndrome post-thrombotique (SPT) est une complication chronique fréquente des thromboses veineuses profondes (TVP) (20 % à 50 %). Il peut être invalidant (5 % à 10 %) avec un impact sur la qualité de vie et les dépenses de santé. Les traitements du SPT sont limités et la prévention est capitale. La reconnaissance de critères échographiques de prédiction de survenue d’un SPT favoriserait une prise en charge précoce. Le reflux et l’obstruction veineuse, à l’origine de l’hyperpression veineuse, sont à rechercher par Echo-doppler dans le suivi d’un épisode de TVP. Le thrombus peut demeurer occlusif, disparaître, avoir embolisé partiellement ou complètement. Bien que ces séquelles ne soient pas corrélées au stade d’insuffisance veineuse elles représentent un facteur reconnu de récidive de la TVP. L’épaississement de la paroi veineuse pourrait être un paramètre intéressant à étudier lors de l’analyse échographique. Elle est le témoin direct du remodelage post-inflammatoire lié au thrombus cependant son importance clinique reste à démontrer par des études.
Sammi ZERROUK
Naborvein institut, St Avold France
Mots clefs : remodelage veineux, syndrome post-thrombotique, insuffisance veineuse chronique
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.
Key-words: venous remodeling, post-thrombotic syndrome, chronic venous insufficiency
Sammi ZERROUK
Naborvein institut, St Avold France
Mots clefs : remodelage veineux, syndrome post-thrombotique, insuffisance veineuse chronique
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.
Key-words: venous remodeling, post-thrombotic syndrome, chronic venous insufficiency