A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results

✍ Scribed by F. A. K. Mazari; T. Mehta; M. N. A. Rahman; P. McCollum; I. C. Chetter

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 85 KB
• Volume: 96
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.6528

✦ Synopsis

association with thrombo-embolic complications and to refine our care of patients with this condition. Method: All patients referred for STP or query DVT, between 2000 and 2008 with STP had a colour flow duplex scan (CFDS). All case notes and scans were available for review. Results: Two hundred and ten patients had STP. Two hundred and ninetyone CFDS were performed and each patient had at least one scan. Predisposing factors to STP included varicose veins (31%), previous DVT/phlebitis (20%), cancer (13%), recent long distance travel (12%), trauma (6%), puerperium (2%) and use of oral contraceptive pills (2%). Thrombus was located along the course of the long saphenous vein in 171 patients (82%) and short saphenous vein in 39 patients (18%). Sixty-four patients (30%) had a thrombo-embolic complication: 57 DVTs; 7 PEs. Fourteen patients had DVT which progressed to PE. Treatment was a variety of combinations of antibiotics, NSAIDS, compression stockings, warfarin, low-molecular-weight heparin and surgical disconnection (28). Eleven patients had a change of treatment plan following a follow-up scan. Conclusion: Our findings show that STP is far from a benign condition with potential life-threatening thrombotic complications occurring in a third of patients. The benefits of operative intervention are unclear and studies are needed to answer this question as well as the best medical management.