Investigation of the Leg Lymphatic Function in Patients with Leg Acute Venous Thrombosis and in Patients with Leg Post-Thrombotic Syndrome

ABSTRACT

Lymphatic and venous systems work together to drain interstitial fluid and blood respectively. Data on lymphatic function in chronic venous insufficiency and in chronic venous ulcerations are discordant. Modification of lymphatic function in acute venous thrombosis have been never described. The aim of this study is to report the modifications of the function of the lymphatic system in acute venous thrombosis, chronic venous ulceration and post-thrombotic syndrome.

Material and Methods:

Patients were studied with qualitative and semi-quantitative lymphoscintigraphy. The transport index (TI 60) have been calculated for each patients. Data obtained in group a (13 patients with acute venous thrombosis) (TI 60 = 398); group b (12 limbs of 6 controls) (TI 60 = 203); group c (10 limbs with chronic venous ulcerations) (TI 60 = 114); group d (6 limbs with post-thrombotic syndrome in absence of ulcerations) (TI 60 = 148) were compared with Kruscall-Wallis statistic and Mann-Whitney test.

Results:

The TI 60 is different in the four groups. Differences are significant between: group a (TI 60 = 398) and group b (TI 60 = 203); group b (TI 60 = 203) and group c (TI 60 = 114); group b (TI 60 = 203) and group d (TI 60 = 148).

Discussion:

The compensatory function of lymphatic system in acute venous thrombosis is definitively demonstrated. The lymphatic drainage of the limb affected by chronic venous ulceration is reduced. After the healing of the ulceration the lymphatic flow of the limbs affected by post-thrombotic syndrome improves but it remains under the levels of normal subjects.

Keywords:

Acute venous thrombosis, lymphoscintigraphy, chronic venous ulceration, post-thrombotic syndrome.