Post-thrombotic syndrome

Post-thrombotic syndrome

Post-thrombotic syndrome develops after a deep vein thrombosis, characterised by swelling, stasis dermatitis, ulceration and venous claudication of the affected limb. Treatment of deep vein thrombosis reduces the risk of development of the syndrome. Prevention of the syndrome is one of the important aims of treatment of deep vein thrombosis, the other important aim being the prevention of pulmonary embolism. Post-phlebitic syndrome is another name used to describe the post-thrombotic syndrome. Compression stockings are useful in the treatment of post-phlebitic syndrome. About one fifth to one half of patients develop post-thrombotic syndrome within one to two years of a symptomatic deep vein thrombosis. Venous ulcers may develop in 5-10% of cases [1].

Important risk factors for the development of post-thrombotic syndrome are extensive deep vein thrombosis, recurrent deep vein thrombosis on the same side, obesity and older age. Persistence of symptoms in the leg after one month has to be taken as an indicator of development of post-thrombotic syndrome [1]. Documenting incompetence of the venous valves is useful in confirming the diagnosis in symptomatic individuals.

The role of thrombolysis and venoactive drugs like sulodexide [2] in preventing post-thrombotic syndrome needs evaluation.

Reference

1. Susan R Kahn. The post-thrombotic syndrome. Hematology Am Soc Hematol Educ Program. 2016 Dec 2;2016(1):413-418.
2. Roberta Luzzi, Gianni Belcaro, Mark Dugall, Shu Hu, Guido Arpaia, Andrea Ledda, Edmondo Ippolito, Marcello Corsi, Andrea Ricci, Roberto Cotellese, Giovanni Agus, Bruno M Errichi, Umberto Cornelli, M Rosaria Cesarone, Morio Hosoi. The efficacy of sulodexide in the prevention of postthrombotic syndrome. Clin Appl Thromb Hemost. 2014 Sep;20(6):594-9.