Post Thrombotic Syndrome (PTS)/ Post Phlebitic Syndrome (PPS)
Post Thrombotic Syndrome (PTS)/ Post Phlebitic Syndrome (PPS) is defined as a syndrome of chronic venous insufficiency (CVI, a medical condition where the veins cannot pump enough oxygen-depleted blood back to the heart). PTS/PPS is caused by damage to the vein walls and valves following a DVT or thrombosis. As a result of incompetent valves and/or persistent venous obstruction from the thrombus, pressure increases in the veins and capillaries causing pain, swelling and redness of the lower leg.
Post Thrombotic Syndrome/ Post Phlebitic Syndrome Prevalence
Post Thrombotic Syndrome (PTS)/ Post Phlebitic Syndrome (PPS) is the most frequent complication of DVT. Statistics reveal that up to 60% of patients who have suffered from Deep Vein Thrombosis will develop PTS. The prevalence of venous ulceration (a shallow wound that develops on the lower leg due to the increase in pressure resulting from the damaged leg veins failing to return blood back to the heart) is at least 300 per 100,000 or 25% of people develop a venous wound following a DVT.
Risk Factors for Developing Post Thrombotic Syndrome/ Post Phlebitic Syndrome
- Age > 65
- Proximal DVT (DVT above the knee)
- Recurrent ipsilateral DVT (A second DVT in same leg as the first DVT)
- Persistent DVT symptoms 1 month after DVT diagnosis
- Poor quality anti-coagulant control during the first 3 months of treatment
Symptoms of Post Thrombotic Syndrome/Post Phlebitic Syndrome
- Chronic Swelling
- Chronic Pain (aching or cramping)
- Chronic Heaviness
- Itching or tingling
- Skin ulcers
- Varicose Veins
- Brownish or reddish skin discoloration
Symptoms may grow worse as the day continues or following long periods of standing but decrease in severity after leg elevation.
The Villalta ScaleDoctors may use the Villalta Scale to diagnosis PTS.
- Includes subjective and objective components
- Diagnosis may get delayed for 3-6 months following a DVT diagnosis because signs and symptoms are similar to those of DVT
Sometimes it is possible to be diagnosed with PTS without being previously diagnosed with a DVT as sometimes DVTs are asymptomatic, where the patient does not show any symptoms.
Chronic Venous Insufficiency (CVI)
Chronic Venous Insufficiency (CVI) occurs when the veins cannot pump enough blood back to the heart. CVI is sometimes referred to as an "impaired musculovenous pump" due to damaged or incompetent valves. Valves in the vein may become damaged after the development of deep vein thrombosis (DVT).
Traditional Treatment for Post Thrombotic Syndrome/Post Phlebitic Syndrome & Chronic Venous Insufficiency (CVI)
- Compression stockings and leg elevation are considered to be the traditional gold standard in PTS treatment- until today.
- Sometimes herbal remedies may be used as well.
- The focus is to reduce venous stasis (stagnant blood in the lower leg).
- Current therapies are limited and often ineffective.
- Compression stockings are often not fitted correctly and patient compliance is poor.