Post thrombotic Syndrome
Godwin Tse
LA-TRAP
Winter 2011
What is post-thrombotic syndrome?
• Long-term complication of deep venous
thrombosis (DVT) that is characterized by
chronic, persistent pain, swelling and other signs
in the affected limb
• Caused by damage to veins and valves
Signs and Symptoms
Signs
• Edema
• Eczema
• Hyperpigmentation
• Redness
• Secondary varicose veins
• Lipodermatoschlerosis
(LDS)
• Venous Ulcers
Symptoms
• Heaviness
• Pain
• Swelling
• Itching
• Cramps
• Aching
• Symptoms worsen with
activity and standing
DVT
Post thombotic syndrome
Risk factors
•
•
•
•
•
•
Age >65
Sex
Location of DVT
Recurrent DVT
Lack of long-term anticoagulation
Obesity
Prevention
• DVT Prophylaxis
• Optimal duration of anticoagulation
After initial DVT:
• Prevention of recurrent DVT
• Compression stockings
Treatment
•
•
•
•
Compression stockings/pump
Elevation of extremity while resting
Lifestyle changes
Medications
PTS vs recurrent DVT
Over 24h span (DVT):
• Dramatic onset of pain
• Persistent swelling
• Duplex ultrasound
▫ May difficult to distinguish due to abnormalities
still present in the venous segment
Social impact
• Costs
▫ Increased medical costs
▫ Lost of productivity at work/home
• Decreased quality of life
References
• http://www.stoptheclot.org/natt_publications/post_thrombotic_sy
ndrome.pdf
• http://www.venousdiseasecoalition.org/diseaseinfo/pts/
• http://www.ncbi.nlm.nih.gov/pubmed/12163001
• http://dermatology.cdlib.org/143/case_presentations/postthrombo
tic_syndrome/vereecken.html
• http://www.inate.org/en/1/2/6/23/default.aspx#Whatispostthrom
boticsymdrome
• http://emedicine.medscape.com/article/461449-overview
• http://www.fvleiden.org/ask/82.html
• http://circ.ahajournals.org/cgi/content/full/121/8/e217