Ask a doctor on the topic of Internal medicine

Thrombosis course and findings

January 18, 2016 | 15,00 EUR | answered by Dr. med. Ive Dr. Schaaf

Dear Dr. Schaaf,

You have already assisted me with advice in the past.

I now have a few questions regarding my current findings and hope you can help me further.

I am currently being treated by two specialist doctors, in Augsburg and Munich.

Here are my findings:

Clinical findings:
1. No visible or palpable signs of venous disease, normal skin trophic, no calf tenderness, no difference in calf circumference left vs. right.
2. Left leg externally normal, normal trophic, no edema, no secondary varicosis, normal pulse status.

Vascular function tests:
1. Lower limb reflux: good, no significant difference compared to the healthy leg.
2. Venous occlusion plethysmography: venous capacity within normal range, delayed venous drainage on the left.

Color Doppler:
1. No more thrombi detectable in the left popliteal vein and no pathological reflux, no evidence of further thrombi in the deep venous system on the left side, slight pathological reflux at the origin of the anterior tibial vein, no reflux in the great saphenous vein and small saphenous vein on the left, with normal flow pattern in the popliteal artery.
2. Main veins adequately patent, popliteal vein completely patent, as well as the posterior tibial veins, no reflux.

Therapy and assessment:
1. Despite complete recanalization of the deep veins, the initiated therapy with Xarelto and wearing compression stockings of class II should be continued for at least another 3 months, follow-up appointment in 3 months.
2. The thrombosed veins have completely recanalized. Mrs. Müller should continue anticoagulation until the end of March, and she must also continue wearing compression stockings consistently, follow-up examination recommended for the end of April.

Now my questions:
I know I have asked this before, but how do you assess the situation based on the findings? 1. is always Augsburg from 04.01.16 and 2. is Munich from 11.01.16. I am specifically concerned about long-term effects and the compression stockings.

Should I be worried about the delayed drainage? Does this mean I have to always wear the stockings? Since hardly any refluxes were detected and the LRR test was good.

What should I expect now? Can you improve or worsen the values?

I am puzzled that the doctor from Augsburg found a slight reflux and the doctor from Munich did not see it at all. What does that mean?

No venous diseases are found. Will it stay that way?

I also have some strange sensations in the thrombosis leg, such as tingling, pinching, and also slight pulling. This doesn't seem to match the findings. Can you tell me what this is about?

I also tried to walk without the stocking for about 15 - 20 minutes. I feel uncertain and wobbly on the leg. It doesn't feel the same as before. Will I get back to my normal leg feeling?

Thank you for your help and I look forward to your response.

Warm regards,

S. Müller

Dr. med. Ive Dr. Schaaf

Good evening,

the findings of both doctors agree. The slight reflux is still normal, the finding could have been omitted.

Your prognosis is really good, as I said, I assume you will not suffer any long-term effects and that you will only need the stockings in situations of stress.

The tingling, etc. is normal, no need to worry, it will go away on its own.

The feeling of uncertainty is also normal. The stocking gives you support, which suddenly disappears when you take it off.

You can slowly start saying goodbye to your many worries.
You were lucky, it turned out well again, that's how I see it.

Best regards

Dr. Ive Schaaf