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Post-thrombotic syndrome is a condition that can happen to people who have had a deep vein thrombosis (DVT) of the leg. The condition can cause chronic pain, swelling, and other symptoms in your leg. It may develop in the weeks or months following a DVT.
Veins are the blood vessels that bring oxygen-poor blood and waste products back to the heart. Arteries are the blood vessels that bring oxygen-rich blood and nutrients to the body. A DVT is a blood clot that forms in a vein deep inside the body. In most cases, this clot forms inside one of the deep veins of the thigh or lower leg.
The veins in your legs have tiny valves that help keep blood moving back up toward the heart. But a DVT may damage one or more of these valves. This causes them to weaken or become leaky. When this happens, blood starts to pool in your legs.
DVT is a common condition, especially in people over age 65. Post-thrombotic syndrome affects a large number of people who have had DVT. It can happen in men and women of any age.
A variety of conditions can increase your chance of getting a DVT, such as:
Certain factors may increase your risk for post-thrombotic syndrome, such as:
In some cases, post-thrombotic syndrome causes only a few mild symptoms. In other cases, it can cause severe symptoms. The symptoms occur in the same leg that had the DVT, and can include:
Your healthcare provider will ask about your medical history, including if you have had a DVT. He or she will ask about your symptoms and give you a physical exam. This will include a careful exam of your leg. You may also need some tests, such as:
Healthcare providers often use something called a Villalta score to assess post-thrombotic syndrome. This scale rates the severity of your symptoms and signs. A score higher than 15 means that you have severe post-thrombotic syndrome.
Compression is the main treatment for post-thrombotic syndrome. This helps to increase the blood flow in your veins, and decrease your symptoms.
You may be given prescription-grade compression stockings. These apply more pressure than the type you can buy over-the-counter. These are worn during the day, on the leg that had the DVT. You also may also be given an intermittent pneumatic compression (IPC) device. This device applies pressure on the veins of your leg.
Proper skin care is also essential. You healthcare provider may advise that you use a product to lubricate your skin, such as petroleum jelly. Barrier creams that contain zinc oxide can also be helpful. In some cases, you may need a steroid cream or ointment to treat your skin. If you develop leg sores (ulcers), they may need special treatment.
In some cases, your provider may advise surgery. This can be done to remove a blockage in a major vein. It can also be done to repair the valves in your leg veins.
Symptoms often improve with treatment, but your symptoms may not all go away. It may help if you:
Post-thrombotic syndrome can cause leg sores (ulcers). If so, you will need to have wound care. Aspirin and a medicine called pentoxifylline may help aid ulcer healing. If an ulcer becomes infected, you may need antibiotics. Severe ulcers that don’t get better with medicines and wound care therapy may need surgery to remove the damaged tissue.
You can reduce your risk of post-thrombotic syndrome by lowering your risk of DVT. Not moving or walking for long periods of time raises your risk of DVT. If you are immobile due to a medical condition or surgery, your healthcare provider will advise you how to prevent DVT. This may include:
Treating DVT right away is the best way to prevent post-thrombotic syndrome. Take blood-thinner medicine exactly as prescribed. Don’t miss any follow-up tests to check your blood levels of the medicine. Use your compression devices exactly as prescribed.
Call your healthcare provider right away if you have:
Tips to help you get the most from a visit to your healthcare provider:
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