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Posttrombotisk syndrom

Sist revidert:
Sist revidert av:


Definisjon:
Vedvarende insuffisiens av klaffer i det dype venesystemet etter tidligere dyp venøs trombose
Forekomst:
Prevalens ca 1-2% av befolkningen
Symptomer:
Typiske symptomer er lokalisert smerte, kløe, parestesier, tyngdefølelse og eventuelt kramper, deklive ødemer, hudsår
Funn:
Typiske funn er smerter, ødem, pigmentering, kronisk eksem og leggsår
Diagnostikk:
Aktuell tilleggsundersøkelse kan være ultralyd med doppler eller duplex
Behandling:
Kompresjonsbehandling står helt sentralt. Elastiske strømper anbefales brukt i rundt to år, ev. lenger dersom det fortsatt er ødemtendens. Hud- og sårbehandling. Fothygiene.
  1. Amin EE, Bistervels IM, Meijer K, et al. Reduced incidence of vein occlusion and postthrombotic syndrome after immediate compression for deep vein thrombosis. Blood. 2018;132(21):2298-2304. PubMed  
  2. Mills JL, Armstrong DG. Chronic venous insufficiency. BMJ Best Practice, last updated Nov 19, 2014.
  3. Kahn SR. The post-thrombotic syndrome. Hematology Am Soc Hematol Educ Program. 2016;2016(1):413-418. PubMed  
  4. Prandoni P, Frulla M, Sartor D, Concolato A, Girolami A. Venous abnormalities and the post-thrombotic syndrome. J Thromb Haemost 2005;3:401–2.
  5. Kahn SR, Partsch H, Vedantham S, Prandoni P, Kearon C. Definition of post-thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization. J Thromb Haemost 2009;7:879–83.
  6. Kahn SR. Measurement properties of the Villalta scale to define and classify the severity of the post-thrombotic syndrome. J Thromb Haemost 2009;7:884–8.
  7. Jain A, Cifu AS. American Heart Association (AHA). Prevention, diagnosis, and treatment of postthrombotic syndrome. JAMA 2016; 315: 1048-9. doi:10.1001/jama.2016.0225 DOI  
  8. Kahn SR, Shapiro S, Wells PS et al. Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial. The Lancet 2014; 383: 880-8. PMID: 24315521.
  9. Kolbach DN, Sandbrink MWC, Prins MH, Neumann MHAM. Compression therapy for treating stage I and II (Widmer) post-thrombotic syndrome. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD004177. DOI: 10.1002/14651858.CD004177. The Cochrane Library  
  10. Kearon C, Akl EA, Ornelas J. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest 2016; 149: 315-52. pmid:26867832 PubMed  
  11. Musani MH, Matta F, Yaekoub AY, et al. Venous compression for prevention of postthrombotic syndrome: a meta-analysis. Am J Med. 2010;123:735-740. PubMed  
  12. Prandoni P, Noventa F, Quintavalla R, et al. Thigh-length versus below-knee compression elastic stockings for prevention of the postthrombotic syndrome in patients with proximal-venous thrombosis: a randomized trial. Blood. 2012;119:1561-1565. PubMed  
  13. Berntsen CF, Kristiansen A, Akl EA, et al. Compression Stockings for Preventing the Postthrombotic Syndrome in Patients with Deep Vein Thrombosis. Am J Med 2015; S0002-9343: 30030-9. doi:10.1016/j.amjmed.2015.11.031 DOI  
  14. O'Meara S, Cullum NA, Nelson EA. Compression for venous leg ulcers. Cochrane Database Syst Rev. 2009;(1):CD000265. The Cochrane Library  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Tore Amundsen, spesialist i indremedisin, lungesykdommer og blodsykdommer, overlege Lungemedisinsk avdeling, St. Olavs hospital og professor, DMF, NTNU