Trial Lecture – time and place
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Adjudication committee
- First opponent: Professor Henrik Sillesen, Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Denmark
- Second opponent: Associate Professor Frode Manstad-Hulaas, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology
- Third member and chair of the evaluation committee: Associate Professor Tone Kristin Bergersen, Institute of Clinical Medicine, University of Oslo
Chair of the Defence
Professor II Arild Nesbakken, Institute of Clinical Medicine, University of Oslo
Principal Supervisor
Senior Consultant Tone Enden, Oslo University Hospital
Summary
Following acute proximal deep vein thrombosis of the lower limb, up to 50% of patients develop chronic leg problems including pain, edema, skin changes, heaviness, venous claudication, and sometimes leg ulcers, known as the post-thrombotic syndrome.
Additional treatment with catheter-directed thrombolysis has previously been shown to improve patency and reduce the frequency of post-thrombotic syndrome with a number needed to treat of seven after two years follow-up. After five years follow-up this benefit was sustained and even improved with a number needed to treat of four.
Two patient groups with chronic deep vein obstructions were studied following placement of endovenous stents. The first group had chronic obstruction of the inferior vena cava, with or without concomitant obstruction of the pelvic or inguinal veins. The second group had unilateral chronic obstruction with infrainguinal involvement. In both groups 7 of 10 patients had symptom improvement following stent placement. No severe complications were reported. In case of stent occlusion the chronic leg problems did not deteriorate compared to baseline.
Overall, the endovascular approach reduced the risk of post-thrombotic syndrome following acute deep vein thrombosis, and lead to symptom improvement in patients with chronic deep vein obstruction.
Additional information
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