The Post-Thrombotic Syndrome (PTS) is a frequent (40%) chronic complication of having a blood clot (DVT) (1, 2). Many patients experience one or more of the following symptoms and signs of PTS on a daily basis, even months and years after their DVT episode:
- leg swelling (“edema”)
- leg aching or pain
- leg heaviness
- leg tiredness or fatigue
- changes in skin color or texture
A small number of patients develop skin breakdown (“’ulcers”) In some cases, symptoms can be managed with modest lifestyle changes (e.g. rest periods with leg elevation). However, when PTS becomes more severe, these symptoms can be disabling, limit physical activities, and result in the following:
- severe “bursts” of pain limiting the ability to walk or exercise (7-10);
- significant swelling in the calf and possibly the thigh limiting activity;
- chronic pain syndromes that often prompt long-term use of pain medications;
- venous ulcers or wounds that significantly impact quality of life and potentially could result in infection and/or require surgical treatment (11)
Disabling PTS can result in work disability, inability to perform household tasks, and major impairment of health-related quality of life (3-6).
1. Baldwin MJ, Moore M, Rudarakanchana N, Gohel M, Davies AH. Post-thrombotic syndrome: a clinical review. J Thromb Haemost 2013; 11:795-805. Jump back to text.
2. Kahn SR, Shrier I, Julian JA, Ducruet T, Arsenault L, Miron M, Roussin A, Desmarais S, Joyal F, Kassis J, Solymoss S, Desjardins L, Lamping DL, Johri M, Ginsberg JS. Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis. Ann Intern Med 2008; 149:698-707. Jump back to text.
3. Kahn SR, Hirsch A, Shrier I. Effect of postthrombotic syndrome on health-related quality of life after deep venous thrombosis. Arch Intern Med 2002; 162:1144-1148. Jump back to text.
4. Beyth RJ, Cohen AM, Landefeld S. Long-term outcomes of deep-vein thrombosis. Arch Intern Med 1995; 155:1031-1037. Jump back to text.
5. Kahn SR, Ducruet T, Lamping DL, Arsenault L, Miron MJ, Roussin A, Desmarais S, Joyal F, Kassis J, Solymoss S, Desjardins L, Johri M, Shrier I. Prospective evaluation of health-related quality of life in patients with deep venous thrombosis. Arch Intern Med 2005; 165:1173-1178. Jump back to text.
6. Kahn SR, Shbaklo H, Lamping DL, Holcroft CA, Shrier I, Miron MJ, Roussin A, Desmarais S, Joyal F, Kassis J, Solymoss S, Desjardins L, Johri M, Ginsberg JS. Determinants of health-related quality of life during the 2 years following deep vein thrombosis. J Thromb Haemost 2008; 6:1105-1112. Jump back to text.
7. O’Donnell TF Jr., Browse NL, Burnand KG, Thomas ML. The socioeconomic effects of an iliofemoral venous thrombosis. J Surg Res 1977; 22:483-488. Jump back to text.
8. Strandness DE, Langlois Y, Cramer M, Randlett A, Thiele BL. Long-term sequelae of acute venous thrombosis. JAMA 1983; 250:1289-1292. Jump back to text.
9. Delis KT, Bountouroglou D, Mansfield AO. Venous claudication in iliofemoral thrombosis: long-term effects on venous hemodynamics, clinical status, and quality of life. Ann Surg 2004; 239(1):118-126. Jump back to text.
10. Akesson H, Brudin L, Dahlstrom JA, Eklof B, Ohlin P, Plate G. Venous function assessed during a 5 year period after acute ilio-femoral venous thrombosis treated with anticoagulation. Eur J Vasc Surg 1990 Feb;4(1):43-48. Jump back to text.
11. Phillips T, Stanton B, Provan A, Lew R. A study of the impact of leg ulcers on quality of life: financial, social, and psychologic implications. J Am Acad Dermatol 1994; 31:49-53. Jump back to text.