ヤマキ　タカシ   八巻　隆    所属   医学部 医学科（附属足立医療センター）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Factors predicting development of post-thrombotic syndrome in patients with a first episode of deep vein thrombosis: preliminary report.
掲載誌名	正式名：European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery 略　 称：Eur J Vasc Endovasc Surg ISSNコード：1532-2165(Electronic)1078-5884(Linking)
巻・号・頁	41(1),pp.126-33
著者・共著者	Yamaki T, Hamahata A, Soejima K, Kono T, Nozaki M, Sakurai H
担当区分	筆頭著者
発行年月	2011/01
概要	OBJECTIVE:To investigate the indicative parameters reflecting the progression of post-thrombotic syndrome (PTS) in patients with a first episode of deep vein thrombosis (DVT).DESIGN AND METHODS:The patients' initial risk factors were assessed at presentation. Venous occlusion, and reflux and reflux parameters were evaluated at 6 months using venous duplex scanning. Near-infrared spectroscopy (NIRS) was also used to measure calf muscle deoxygenated haemoglobin levels at 6 months. Clinical manifestations were categorised using the clinical, etiologic, anatomic and pathophysiologic (CEAP) classification for chronic venous insufficiency (CVI), and the patients were divided into those having no PTS (C(0-3S),E(s),A(s,d,p),P(r,o)) and those having PTS (C(4-6S),E(s),A(s,d,p),P(r,o)).RESULTS:Of the 121 patients evaluated, 25 (21%) developed PTS with a mean follow-up period of 66 months. At initial presentation, ilio-femoral DVT (odds ratio (OR) 3.4, 95% confidence interval (CI) 1.4-8.6) was associated with development of PTS. At 6 months, venous occlusion combined with reflux (OR 4.4, 95% CI 2.9-20.7), peak reflux velocityRESULTS:>RESULTS:29.7 cm s(-1) (OR 13.7, 95% CI 4.1-45.7) and mean reflux velocityRESULTS:>RESULTS:8.6 cm s(-1) (OR 4.4, 95% CI 1.5-12.9) in the popliteal vein detected by duplex scanning were strong predictors of PTS. NIRS-derived retention indexRESULTS:>RESULTS:3.5 was the strongest predictor of PTS at 6 months (OR 67.4, 95% CI 14.3-318.1).CONCLUSIONS:Ilio-femoral DVT is associated with the development of PTS at initial presentation. By contrast, occlusion and reflux, high reflux velocity in the popliteal vein and increased NIRS-derived retention index are important time-course predictors of PTS progression.
DOI	10.1016/j.ejvs.2010.09.018
文献番号	21112226