Pathogenesis of the postphlebitic syndrome.

The dependent edema, skin pigmentation, local inflammation associated with subcutaneous fibrosis, chronic ulceration, and current infection are the hallmarks of postphlebitic syndrome. In one fifth of the patients there is no evidence of antecedent deep venous occlusion. Current emphasis is therefore on improvement in investigation and the use of treatment programs designed to return venous patency and valve function to normal. Modern management must also take into account local changes in capillary permeability and fibrinolytic activity in the pathogenesis of the venous ulceration.