Diagnosis of venous thrombosis and the post-thrombotic syndrome

Tick, L.W. (2008)

Doctoral Thesis

In the first part of this thesis we described two new diagnostic algorithms for patients with clinically suspected deep venous thrombosis and pulmonary embolism. These management strategies include both pretest clinical probability and D-dimer assay, and reduce the need for non-invasive imaging tests. These novel strategies are safe in excluding deep venous thrombosis and pulmonary embolism. The results of the first part of this thesis led to a different, more simple diagnostic strategy in patients with venous thromboembolism. In the second part of this thesis we described two follow-up studies which led to the identification of new risk factors and early predictors for PTS. At present, the results of these studies enable us to provide individualized information to patients with a first deep venous thrombosis about their risk for the development of PTS. Future research should focus on validating and standardizing diagnostic criteria for PTS. A standardized diagnosis is necessary to improve the uniformity of the diagnosis and to enhance the ability to compare results of different studies. Moreover, objective diagnosis of PTS will allow physicians to monitor the development and course of PTS in their own patients.

• Clinical Decision Rule
• D-dimer
• Deep Venous Thrombosis
• Diagnosis
• Post-Thrombotic Syndrome
• Pulmonary Embolism
• Venous Thromboembolism

• All authors: Tick, L.W.
• Supervisor: Rosendaal, F.R.; Kramer, M.H.H.
• Co-supervisor: Doggen, C.J.M.; Huisman, M.V.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2008-09-24
• ISBN (print): 9789071382390