Post-Thrombotic Syndrome: Causes, Symptoms and Prevention


Post-thrombotic syndrome (PTS - also known as venous stress disorder and post-phlebitic syndrome) refers to various complications which can arise from deep vein thrombosis (DVT), particularly if left untreated. It is more likely to occur in patients who are significantly overweight or who have experienced more than on instance of DVT in the same limb.


PTS is thought to be caused by damage and inflammation to the vein and its valves during an episode of DVT. This can in turn result in damage to surrounding tissues and superficial veins, all manifesting in a number of possible symptoms which often prove uncomfortable and sometimes debilitating.


Common PTS symptoms include varicose veins, swelling, discolouration of the skin, feelings of heaviness, itching or tingling within the leg, pain, a rash and in severe cases ulceration. These symptoms are usually exacerbated by walking or standing for any length of time. The appearance of any of these symptoms in a patient known to have experienced DVT form a key part of PTS diagnosis. However, in some cases the use of ultrasound or venography may also prove necessary.


Effective treatment of DVT is key to preventing post-thrombotic syndrome and various methods may be employed to this end, including the use of anticoagulant drugs, exercise, raising the legs when seated and wearing compression stockings for up to two years following the DVT. For obese patients a program of weightloss may also be recommended.

Compression stockings also form a significant element in the treatment of PTS and its associated symptoms and are available in a variety of grades, colours and styles. Some drug treatments are also prescribed in certain cases and severe trauma may require surgery to rectify the problem. If ulcers or other skin problems have occurred then regular cleaning and good hygiene are essential to minimise the risk of infection.

Exercise is also significant in encouraging and maintaining healthy blood flow and compression stockings should be worn for any physical activity. Walking is particularly beneficial and long periods of inactivity should be avoided. When sitting, simple rotations of the feet and ankles can help, as can elevation of the legs to above the hips. Good hygiene is essential to prevent infection and any ulcers should be cleaned regularly.