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Post-Thrombotic Syndrome

Topic Overview

Post-thrombotic syndrome (PTS) is a complication of deep vein thrombosis (DVT), or deep vein blood clot. After a while, this blood clot (usually in your leg), can damage the vein.

Damage to the vein can lead to more pressure in the veins. The increased pressure can cause long-term problems such as swelling, skin damage, and painful sores (venous skin ulcers) near the ankle.

PTS can be a long-term problem that lasts for years.

PTS is also called postphlebitic syndrome.

What are the symptoms?

Symptoms of post-thrombotic syndrome include:

  • Brownish discoloration of the skin.
  • Itching, swelling, slow-healing sores, and pain in the area.
  • Fragile skin on the area, which bruises easily. The skin may be dry and may peel.

How is it treated?

You may need to wear specially fitted compression stockings to treat PTS. You may need to use an intermittent pneumatic compression device. These devices inflate and deflate knee-high boots. These stockings and devices may help with pain and swelling. If you have sores, you may need medicines and bandages to help the sores heal.

Your doctor may prescribe pain medicines. Propping up your leg may reduce pain and swelling.

You might try an exercise program to help relieve PTS symptoms. Talk with your doctor before starting a new exercise program. Your doctor might recommend strength training for your legs and aerobic exercise, such as walking.

For people who have severe symptoms and have a risk of serious problems, surgery or a catheter procedure might be done to restore blood flow. These procedures are not commonly done.

How is post-thrombotic syndrome prevented?

The treatment of DVT with anticoagulant medicine may help prevent post-thrombotic syndrome.

Thrombolytic medicines are not commonly used, but they may be given to treat DVT. They may help prevent PTS. These medicines can quickly dissolve a blood clot, but they also greatly increase the risk of serious bleeding.

References

Other Works Consulted

  • Guyatt GH, et al. (2012). Executive summary: Antithrombotic therapy and prevention of thrombosis, 9th ed.-American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2, Suppl): 7S-47S.
  • Kahn SR, et al. (2014). Compression stockings to prevent post-thrombotic syndrome: A randomised placebo-controlled trial. Lancet, 383(9920): 880-888. DOI: http://dx.doi.org/10.1016/S0140-6736(13)61902-9. Accessed December 31, 2014.
  • Kahn SR, et al. (2014). The postthrombotic syndrome: Evidence-based prevention, diagnosis, and treatment strategies. A scientific statement from the American Heart Association. Circulation, 130(18): 1636-1661. DOI: 10.1161/CIR.0000000000000130. Accessed April 28, 2015.
  • Kearon C, et al. (2012). Antithrombotic therapy for VTE disease. Chest, 141(2, Suppl): e419S-e494S.
  • Kearon C, et al. (2016). Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest, 149(2): 315-352. DOI: 10.1016/j.chest.2015.11.026. Accessed March 1, 2016.

Credits

ByHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
E. Gregory Thompson, MD - Internal Medicine
Martin J. Gabica, MD - Family Medicine
Specialist Medical ReviewerJeffrey J. Gilbertson, MD - Vascular Surgery

Current as ofNovember 21, 2017


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