Scoring Systems for Postthrombotic Syndrome

Abstract Postthrombotic syndrome (PTS) is the most common long‐term complication after deep vein thrombosis (DVT) and is associated with reduced quality of life. There is no single objective test to diagnose the presence of PTS and it is usually diagnosed on the basis of typical symptoms and signs in a limb previously affected by DVT. Scoring systems for PTS are primarily developed as research tools, but could possibly also be useful in the clinical setting. A main advantage of a good scoring system is standardization of the diagnostic process. An optimal scoring system should be both sensitive and specific for PTS, but this has been difficult to achieve because the symptoms and signs of PTS can be similar to other conditions leading to complaints in the lower limb. In an effort to standardize the definition of PTS, in 2009, the International Society on Thrombosis and Haemostasis Subcommittee on Control of Anticoagulation reviewed available scales and recommended use of the Villalta scale as the most appropriate measure to diagnose and grade the severity of PTS. The aim of this article is to review the existing scoring systems for PTS and to present our view on the advantages and disadvantages of these diagnostic tools.

[1]  W. P. Arnold,et al.  One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial , 2016, British Medical Journal.

[2]  Inter-rater agreement between professional-rated and patient-rated scores of the Villalta scale for evaluation of the post-thrombotic syndrome. , 2016, Thrombosis research.

[3]  S. Kahn,et al.  Development and validation of a tool for patient reporting of symptoms and signs of the post-thrombotic syndrome , 2016, Thrombosis and Haemostasis.

[4]  L. Sandvik,et al.  Post-thrombotic syndrome after catheter-directed thrombolysis for deep vein thrombosis (CaVenT): 5-year follow-up results of an open-label, randomised controlled trial. , 2016, The Lancet. Haematology.

[5]  P. Prandoni,et al.  The postthrombotic syndrome: evidence-based prevention, diagnosis, and treatment strategies: a scientific statement from the American Heart Association. , 2014, Circulation.

[6]  Christina Holcroft,et al.  Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial , 2014, The Lancet.

[7]  M. Meissner,et al.  A comparison of Villalta-Prandoni scale and venous clinical severity score in the assessment of post thrombotic syndrome. , 2014, Annals of vascular surgery.

[8]  S. Kahn,et al.  Comparison of the Villalta post‐thrombotic syndrome score in the ipsilateral vs. contralateral leg after a first unprovoked deep vein thrombosis , 2012, Journal of thrombosis and haemostasis : JTH.

[9]  L. Sandvik,et al.  Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial , 2012, The Lancet.

[10]  D. Lamping,et al.  Economic burden and cost determinants of deep vein thrombosis during 2 years following diagnosis: a prospective evaluation , 2011, Journal of thrombosis and haemostasis : JTH.

[11]  W. Marston,et al.  Revision of the venous clinical severity score: venous outcomes consensus statement: special communication of the American Venous Forum Ad Hoc Outcomes Working Group. , 2010, Journal of vascular surgery.

[12]  S. Kahn How I treat postthrombotic syndrome. , 2009, Blood.

[13]  V. Anastassov,et al.  Prevalence of primary chronic venous disease: the Bulgarian experience. , 2009, International angiology : a journal of the International Union of Angiology.

[14]  P. Prandoni,et al.  Definition of post‐thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization , 2009, Journal of thrombosis and haemostasis : JTH.

[15]  M. den Heijer,et al.  Inflammation in deep vein thrombosis and the development of post‐thrombotic syndrome: a prospective study , 2009, Journal of thrombosis and haemostasis : JTH.

[16]  D. Lamping,et al.  Determinants of health‐related quality of life during the 2 years following deep vein thrombosis , 2008, Journal of thrombosis and haemostasis : JTH.

[17]  S. Kahn,et al.  Comparison of the Villalta and Ginsberg clinical scales to diagnose the post‐thrombotic syndrome: correlation with patient‐reported disease burden and venous valvular reflux , 2006, Journal of thrombosis and haemostasis : JTH.

[18]  O. Linder,et al.  Post‐thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolism treated with warfarin for 6 weeks or 6 months , 2006, Journal of thrombosis and haemostasis : JTH.

[19]  M. Prins,et al.  Definition of the post-thrombotic syndrome, differences between existing classifications. , 2005, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[20]  G. Moneta,et al.  Revision of the CEAP classification for chronic venous disorders: consensus statement. , 2004, Journal of vascular surgery.

[21]  A. Mansfield,et al.  Venous Claudication in Iliofemoral Thrombosis: Long-term Effects on Venous Hemodynamics, Clinical Status, and Quality of Life , 2004 .

[22]  S. Nicholls,et al.  Performance characteristics of the venous clinical severity score. , 2002, Journal of vascular surgery.

[23]  M Gent,et al.  Prevention and treatment of postphlebitic syndrome: results of a 3-part study. , 2001, Archives of internal medicine.

[24]  H. Buller,et al.  Postthrombotic syndrome after hip or knee arthroplasty: a cross-sectional study. , 2000, Archives of internal medicine.

[25]  H. Büller,et al.  Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis , 1997, The Lancet.

[26]  Gregory L. Moneta,et al.  Reporting standards in venous disease: An update , 1995 .

[27]  E. Zemp,et al.  Late results in deep vein thrombosis of the lower extremity. , 1985, VASA. Zeitschrift fur Gefasskrankheiten.