Clinical Analysis of Deep Vein Thrombosis in Lower Extremity

Yoon, Jong Seop; Son, Byung Ho; Kim, Yong Shin

Abstract

PURPOSE: The natural history of deep vein thrombosis (DVT) has been of increasing interest since the mid-1960s. Prevention, diagnosis & management of DVT has been continously development. Howerver, Early diagnosis for prevention & effectivly choice of management method of DVT has been difficult problem.
METHODS
We reviewed retrospectively 42 patients who were admitted and out patients department follow up to Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, for treatment of DVT from November, 1990 to August, 1998.
RESULTS
There was a wide age distribution from teenage to 9th decade, and peak age distribution was 7th decade (23.8%). It occured more old age than younger age. Sex distribution, male to female, was about 1.2 : 1 and occured more male than female. Main chief complaint in pateints with DVT at initial our hospital visit was painful swelling (57.1%), and followed by swelling (33.3%) of lower extremity. Duration of sign and symptom in pateints with DVT at initial our hospital visit was more than 1 month (38.1%), and followed by less than 1 weeks (31.0%). The left side of lower extermities was more frequently involved than that of right side, left to right ratio was 2.1:1. Most location of involved vein of lower extremity was Popliteal vein (71.4%), and followed by Superficial femoral vein (55.4%), Calf vein (44.6%), and Common femoral vein (39.4%) in ration of 56 limbs. More frequent risk factor of DVT was major surgery (28.6%), and followed by immobility (16.7%). but most frequent risk factor was idiopathic (31.0%). Diagnosis of DVT was made with color doppler (90.5%) and venogram (57.1%). Treatment was done with intravenous or oral anticoagulants in most pateints (90.5%), Forgarty thrombectomy (7.1%), and Bypass and A.-V. fistula (2.4%) and followed by only or combined oral anticoagulants theraphy. Treatment of DVT was wide duration from less than 3 month to more than 1 years. It was done for less than 3 month (52.4%), and followed by 6 to 12 month (19.0%), 3 to 6 month (14.3%) and 14.3% were continued more than 1 years. During oral anticoagulant theraphy, GOT/GPT elevation was observed in 26.2%, and 23.8% was detected bleeding tendency (hematuria). Post-treatment response of DVT was divided three group, good (31.0%), moderated (42.9%), no response group (26.3%) in pateint complaint of before or after treatment. Most pateint were improved in 3 month.
CONCLUSION
We have been thick that DVT in the lower extremity must done early diagnosis and choiced more massively intensively method of treatment and with only or combined oral anticoagulant therapy after operation was prevented for reccured and serious complication.