Interventionelle Therapie des postthrombotischen Syndroms

Background. Postthrombotic syndrome (PTS) is the development of symptoms and signs of chronic venous insufficiency following deep vein thrombosis (DVT), which has a significant negative effect on the quality of life. The current understanding is that the clinical manifestation of PTS is more related to venous obstruction than to venous reflux. In the last decade the use of interventional techniques for the treatment of venous obstructions and occlusions has drastically increased. Objective. This article summarizes the current concept of endovenous and hybrid interventions and presents our concept for optimization of the treatment in patients with symptomatic chronic venous obstruction. Method. A systematic literature search in the medline library was performed to identify relevant studies on the treatment of patients with PTS. Results. A meta-analysis of the relevant studies showed that this minimally invasive operation is an effective treatment option with a low rate of morbidity and no mortality. Use of the newly developed dedicated venous stents showed promising results with good short-term patency rates, as well as a significant decrease of related symptoms. Conclusion. Endovenous interventions have become the method of choice in the treatment of symptomatic chronic venous obstruction. More studies are needed to evaluate the long-term success rate of dedicated venous stents.