ABSTRACT
Thrombosis of the deep veins (deep vein thrombosis; DVT) in the lower limb and pelvis is a frequent and important disorder with potentially serious clinical sequelae. Its annual incidence is estimated at 1 per 1000 in the overall population, but increases steeply after the age of 65. It thus ranks as one of the more common cardiovascular disorders. Pain and swelling of the leg secondary to venous obstruction and perivenous inflammation are the prominent early symptoms. Occasionally, extensive swelling may lead to ischemia with threatening gangrene of the extremity, a condition known as phlegmasia coerulea dolens. The detachment of fresh thrombus fragments causes pulmonary embolism (PE), the most feared short-term complication, which can be fatal. Chronic venous hypertension is the result of persisting venous obstruction and damage to the venous valves. It in turn induces chronic edema, fibrin deposition in the interstitial tissue, poor oxygen exchange, and skin changes. Episodes of painful inflammation of the perimalleolar skin develop and therapyresistant venous ulcers follow. This is the full-blown picture of a postthrombotic syndrome (PTS), the chronic late complication of DVT of the leg.
