The post-thrombotic syndrome (PTS), is a significant consequence of deep venous thrombosis (DVT). Based on studies with long-term follow-up (longer than a year), it is approximated that PTS develops in 20% to 50% of patients with DVT, and the condition is quite taxing and potentially debilitating which reduces the patient’s quality of life.
Deep vein thrombosis (DVT)
Veins in your arms and legs have small valves inside that facilitate the flow of blood in a single direction, towards the heart, defying gravity. When a clot (thrombosis) or blockage develops in the deep veins along the path of blood flow, the valves in the veins get severely damaged. This is called as Deep vein thrombosis, often found in the large veins in the leg.
Diagnosis of PTS
PTS is termed as “syndrome” due to the associated symptoms and clinical signs of the condition that vary from one patient to another.
Pain, heaviness, swelling, cramping, tingling, or itching are symptoms that may occur persistently or may be intermittent. Signs of PTS that may be noted on physical examination of the limb include edema, moderate to severe pain, brownish pigmentation, and venous eczema. Secondary varicose veins may occur, and thickening of the subcutaneous tissues of the lower limb may develop. A more dreaded complication is the presence and recurrence of venous leg ulcers which are typically persistent, painful, and slow to heal.
Why does PTS develop after DVT?
The primary cause of PTS is when the vein valves and walls become damaged and scarred as a result of a DVT. Scarred veins fail to expand as normal veins do and hence with increased blood flow, it causes a throbbing pain and swelling in your lower legs.
DVT can lead to chronic venous hypertension due to persistent venous obstruction and vein reflux and PTS is understood to occur as its consequence. Venous hypertension may lead to impaired venous return and abnormal function of the blood vessels and tissues with increased tissue permeability, and subsequently the characteristic clinical manifestations of PTS.
Prompt diagnosis and treatment of a DVT is necessary to prevent this damage from occurring, as once the valves and walls of the vein are damaged, they cannot be permanently repaired.
How is PTS diagnosed?
There exists no gold standard imaging test that establishes the diagnosis of PTS.
PTS is clinically diagnosed based on the presence of typical symptoms and signs in a patient with a history of DVT.
Generally, it is recommended to defer a diagnosis of PTS until the acute phase of DVT (3-6 months) has passed since it can take a few months for the initial pain and swelling associated with acute DVT to resolve. If a patient with previously documented DVT develops clinical features compatible with PTS, generally no further diagnostic investigation is required.
However, based on reported studies, symptoms of PTS usually manifest within 3 to 6 months after DVT, but can occur up to 2 years or longer also.
If you are looking for vascular experts to diagnose and treat DVT, visit Avis Vascular Centre. The center offers USFDA-approved treatments which can remove the deceased veins in a single session.
Effective pain medications are available and doctors also prescribe blood thinners to prevent further clots from being formed. Compression therapy, stockings, and exercise are also found to be helpful.
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