Skin necrosis as a complication of compression in the treatment of venous disease and in prevention of venous thromboembolism

Michel PERRIN Vascular Surgeon, Chassieu, France BACKGROUND The main concern with compression treatment for chronic venous disease of the lower limb remains compliance, which is difficult to assess depending on the clinical status. Complications like skin allergic reaction and eczema,1 and nerve palsy,2 have been reported, but the most severe is skin necrosis in diabetics or patients with peripheral arterial disease of the lower limbs. There is a consensus for contraindicating compression in patients whose ankle/brachial index (ABI) is less than 0.6, but the arterial disease is not always identified. Diabetes also carries a potential risk of skin wound, but…

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Current status of thrombolysis for acute deep venous thrombosis

Anthony J. COMEROTA, Marilyn H. GRAVETT Jobst Vascular Center University of Michigan The Toledo Hospital, OH, USA ABSTRACT An important question involving the management of patients with acute deep venous thrombosis (DVT) is whether thrombus removal improves outcome, either by reducing postthrombotic morbidity or reducing recurrence rates. Eliminating thrombus is intuitively appealing since persistent thrombus causes venous obstruction and destroys valve function, leading to ambulatory venous hypertension and, ultimately, symptoms of the postthrombotic syndrome. Natural history studies of acute DVT have demonstrated that when spontaneous lysis of thrombus occurs, valve function is preserved, especially when lysis occurs within 1-2 months…

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