Thrombosis Knowledge Centre
Venous Thromboembolism
What is post-thrombotic syndrome?
Post-thrombotic syndrome is a potential long-term complication of DVT resulting from the impaired return of blood through
the veins of the lower leg to the heart. Post-thrombotic syndrome usually arises within two years after DVT.
Clinical symptoms:
- Pain, heaviness, swelling, cramps, itching or tingling
- Aggravated by standing or walking
- Improved with rest or recumbency
Post-thrombotic syndrome is a frequent complication of DVT: 20% to 50% of patients within one to two years of symptomatic DVT.
Post-thrombotic syndrome results from chronic venous hypertension after DVT due to:
- Venous reflux after valvular damage following recanalisation of the vein, or
- Persistent venous obstruction
Diagnosis
- It is important to monitor clinical signs persisting 3 to 6 months after DVT
- Oedema
- Telangectasia
- Hyperpigmentation
- Eczema
- Varicose veins
- Ulceration in severe cases
- Lipodermatosclerosis in severe cases
- Plethysmography: to evidence venous valvular incompetence
Predictive factors
Characteristics of DVT:
- Recurrent ipsilateral DVT
- Proximal versus distal DVT: uncertain
- Symptomatic versus asymptomatic DVT: uncertain
Patient characteristics:
- Increasing age
- Female sex
- Hormonal therapy
- Obesity
- Varicose veins
Surgical characteristics:
- abdominal surgery
Kahn and Ginsberg. Arch Intern Med 2004;164:17-26;
Kyrle and Eichinger. Lancet 2005;365:1163-74