Highlights
- •PTS can be more easily prevented by preventing first or recurrent DVT, than treated.
- •Optimal anticoagulation is essential to reduce the risk and severity of PTS.
- •Patients with iliofemoral DVT may require a more aggressive treatment approach over anticoagulation alone.
- •Treatment of PTS is primarily based on compression therapy.
- •Selected patients with severe PTS can be referred for consideration of interventional procedures in expert centers.
Abstract
Post-thrombotic syndrome (PTS) is a complication that develops in up to 50% of patients
with deep vein thrombosis (DVT) and manifests as symptoms and signs of chronic venous
insufficiency of varying severity. PTS negatively affects patient's quality of life
and causes significant burden to the healthcare system. The risk for PTS development
can be markedly reduced by preventing DVT and providing appropriate anticoagulation
once it develops. Patients with extensive proximal (iliofemoral) DVT may benefit from
invasive interventions, such as catheter-directed thrombolysis. The effectiveness
of elastic compression stockings (ECS) for PTS prevention has not been conclusively
demonstrated in randomized trials.
Treatment of PTS is primarily based on ECS, exercise and lifestyle modifications.
The effectiveness of various pharmacologic agents for PTS treatment remains controversial.
Surgical or radiological interventions for vein reconstruction or revascularization
may be considered in refractory cases.
This review summarizes current evidence regarding prevention and treatment of PTS
of the lower limbs in adults.
Keywords
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Article info
Publication history
Published online: July 14, 2017
Accepted:
July 10,
2017
Received in revised form:
June 19,
2017
Received:
March 30,
2017
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