Table of ContentsView AllTable of ContentsPTS After a DVTCausesSymptomsWhen to Seek Medical CareDiagnosisTreatment and ManagementPreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
PTS After a DVT
Causes
Symptoms
When to Seek Medical Care
Diagnosis
Treatment and Management
Prevention
Frequently Asked Questions
Post-thromboticsyndrome (PTS) is a painful condition that happens to some people who have previously had adeep vein thrombosis(DVT)—a blockage in one of their veins deep in their body. Post-thrombotic syndrome can cause leg pain, leg ulcerations, and swelling.
Post-thrombotic syndrome isn’t diagnosed right after you have a DVT. You might be diagnosed with PTS three months to two years after your initial DVT.
This article discusses some of the causes and symptoms of post-thrombotic syndrome, as well as its diagnosis, treatment, and other related topics.
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Post-Thrombotic Syndrome After a DVT
Where Does DVT Occur?DVTs most commonly occur in the leg, especially the calf. However, it is also possible to get a DVT (and post-thrombotic syndrome) in other parts of your body, like your arm.
Where Does DVT Occur?
DVTs most commonly occur in the leg, especially the calf. However, it is also possible to get a DVT (and post-thrombotic syndrome) in other parts of your body, like your arm.
In most people, symptoms of a DVT completely go away within a month or so. However, in some people, it causes more long-term symptoms, called post-thrombotic syndrome. Some of the symptoms following the DVT may never fully go away, and some new ones can appear.
Estimates vary, but between 20% and 50% of people experience post-thrombotic syndrome after having a DVT. About 5% of people experience severe PTS symptoms.
Causes of Post-Thrombotic Syndrome
Post-thrombotic syndrome develops after one or more blood clots block flow in one of yourveins. These clots can take a while to go away and, in some cases, the blockage only partly diminishes.
The initial DVT can cause inflammation that damages valves found inside your veins, the ones that normally keep blood from flowing backward.
When valves are damaged, the blood pressure inside the veins of your leg becomes higher than normal. This leads to the symptoms of post-thrombotic syndrome, such as swelling and pain in the calf.
How Blood Flows Through the Heart and Lungs
Post-Thrombotic Syndrome Risk Factors
Some people have risk factors that put them at higher risk of getting post-thrombotic syndrome, such as:
People who are promptly treated for their initial DVT withanticoagulantmedications(blood thinners) are less likely to develop post-thrombotic syndrome.
What Is DVT?
What Are the Symptoms of Post-Thrombotic Syndrome?
Symptoms of post-thrombotic syndrome can range from mild to severe problems that significantly impact your quality of life. Some potential signs and symptoms include:
How long does post-thrombotic syndrome last?PTS is a chronic condition, so symptoms may continue for many months.Symptoms might come and go, or they may persist. They may be worse while standing or walking and better while resting and elevating the leg.
How long does post-thrombotic syndrome last?
PTS is a chronic condition, so symptoms may continue for many months.Symptoms might come and go, or they may persist. They may be worse while standing or walking and better while resting and elevating the leg.
Post-Thrombotic Syndrome Vs. New Blood Clot
Some of the symptoms of post-thrombotic syndrome are similar to those you might experience from a blood clot causing anewDVT (e.g., leg pain and swelling).Sometimes it may be difficult to tell these two conditions apart.
If you develop post-thrombotic syndrome, you will get a sense of your own regular symptoms. If you are having pain and swelling that is about the same as usual, it’s unlikely that you have a new blood clot. However, if your symptoms suddenly worsen, you should seek immediate medical treatment.
If necessary, your healthcare provider can perform furtherdiagnostic teststo see if you have a new DVT that needs treatment.
Symptoms of Deep Vein Thrombosis
When to See a Healthcare Provider With PTS Symptoms
If you have previously had a DVT, you will need regular follow-up care with your healthcare provider. They can monitor your symptoms as they diminish after your initial DVT. They can also be alert to the possibility of post-thrombotic syndrome and get you diagnosed promptly.
If your leg just hasn’t returned to normal a couple of months after your DVT, tell your healthcare provider. Let them know if your symptoms went away but seem to have come back.
How Is Post-Thrombotic Syndrome Diagnosed?
A medical professional will review your medical history and current symptoms, and perform a physical exam. Having DVT in the past is a significant indicator of potential post-thrombotic syndrome.
Because the symptoms from an initial DVT can take a while to go away, people aren’t usually officially diagnosed with post-thrombotic syndrome until three to six months post-DVT.Until then, the symptoms still might be from the initial DVT and not from more permanent changes.
When Is Post-Thrombotic Syndrome Diagnosed?Post-thrombotic syndrome is usually diagnosed within a couple of years after a person has had their DVT.
When Is Post-Thrombotic Syndrome Diagnosed?
Post-thrombotic syndrome is usually diagnosed within a couple of years after a person has had their DVT.
Can Post-Thrombotic Syndrome Be Cured?
Unfortunately, treatment for post-thrombotic syndrome is very limited. There aren’t good treatments to improve symptoms or reverse the changes that cause the condition.
Some clinicians recommend continuing anticoagulation treatment in people with post-thrombotic syndrome. These medications are initially prescribed in people who have a DVT to stop the clot from getting bigger and prevent it from traveling to the lungs (pulmonary embolism).
Other healthcare providers may prescribe other pharmaceuticals, likediureticdrugsor drugs that affect the veins, like Defitelio (defibrotide).However, there isn’t good evidence that any of these approaches are very helpful.
Some approaches that may be helpful include:
How to Dissolve Blood Clots in Legs
Exercise With Post-Thrombotic Syndrome
Exercise is another important component of managing post-thrombotic syndrome. Although exercise may temporarily worsen your symptoms if you overdo it, it may help reduce your symptoms over time.
Your healthcare provider can work with you to suggest exercises that will be practical for you. These can help you improve your leg strength, flexibility, and overall cardiovascular health.
Exercise can be particularly helpful if you’re overweight. In those instances, a diet promoting weight loss may also help reduce symptoms.
Preventing Deep Vein Thrombosis
Summary
Post-thrombotic syndrome is a medical complication that happens in some people who have previously had deep vein thrombosis. After one or more blood clots block flow in one of the veins, post-thrombotic syndrome can develop if the DVT causes long-term damage to the veins, causing symptoms such as leg pain and swelling.
A diagnosis of post-thrombotic syndrome is often delayed due to the prolonged nature of DVT symptoms. Treatment varies at this point, often incorporating anticoagulation drugs, compression stockings, and, in severe cases, surgery. Exercise and other lifestyle interventions are a cornerstone of prevention.
The symptoms of post-thrombotic syndrome may diminish with treatment as you find ways to minimize them. However, your leg may never be completely as it was before. (In contrast, initial symptoms from a DVT do go away completely in many people within a few weeks.)Learn MoreSymptoms of Deep Vein Thrombosis
The symptoms of post-thrombotic syndrome may diminish with treatment as you find ways to minimize them. However, your leg may never be completely as it was before. (In contrast, initial symptoms from a DVT do go away completely in many people within a few weeks.)
Learn MoreSymptoms of Deep Vein Thrombosis
Learn MorePreventing Deep Vein Thrombosis
Maybe. Some people with post-thrombotic syndrome have severe symptoms that may prevent them from being able to return to their normal work (e.g., severe pain).However, people with milder or waxing and waning symptoms might not qualify. Additionally, people who have a DVT but do not get post-thrombotic syndrome are unlikely to qualify. Your health care provider can connect you with someone who can help you investigate.
Learn MoreHow to Look Up an ICD Code for Your Diagnosis
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kahn SR.The post-thrombotic syndrome.Hematology Am Soc Hematol Educ Program. 2016;2016(1):413-418. doi:10.1182/asheducation-2016.1.413Rabinovich A, Kahn SR.How I treat the postthrombotic syndrome.Blood. 2018;131(20):2215-2222. doi:10.1182/blood-2018-01-785956Makedonov I, Kahn SR, Galanaud JP.Prevention and management of the post-thrombotic syndrome.J Clin Med. 2020 Mar 27;9(4):923. doi:10.3390/jcm9040923Oxford University Hospitals.Information for People At-Risk for Post-Thrombotic Syndrome.Centers for Disease Control and Prevention.What is venous thromboembolism?Palacios FS, Rathbun SW.Medical treatment for postthrombotic syndrome.Semin Intervent Radiol. 2017;34(1):61-67. doi:10.1055/s-0036-1597765Cazaubon M.Deep vein thrombosis and air travel: Risk management in 2015.Phlebolymphology. 2015; 22(85):25-32.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kahn SR.The post-thrombotic syndrome.Hematology Am Soc Hematol Educ Program. 2016;2016(1):413-418. doi:10.1182/asheducation-2016.1.413Rabinovich A, Kahn SR.How I treat the postthrombotic syndrome.Blood. 2018;131(20):2215-2222. doi:10.1182/blood-2018-01-785956Makedonov I, Kahn SR, Galanaud JP.Prevention and management of the post-thrombotic syndrome.J Clin Med. 2020 Mar 27;9(4):923. doi:10.3390/jcm9040923Oxford University Hospitals.Information for People At-Risk for Post-Thrombotic Syndrome.Centers for Disease Control and Prevention.What is venous thromboembolism?Palacios FS, Rathbun SW.Medical treatment for postthrombotic syndrome.Semin Intervent Radiol. 2017;34(1):61-67. doi:10.1055/s-0036-1597765Cazaubon M.Deep vein thrombosis and air travel: Risk management in 2015.Phlebolymphology. 2015; 22(85):25-32.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kahn SR.The post-thrombotic syndrome.Hematology Am Soc Hematol Educ Program. 2016;2016(1):413-418. doi:10.1182/asheducation-2016.1.413Rabinovich A, Kahn SR.How I treat the postthrombotic syndrome.Blood. 2018;131(20):2215-2222. doi:10.1182/blood-2018-01-785956Makedonov I, Kahn SR, Galanaud JP.Prevention and management of the post-thrombotic syndrome.J Clin Med. 2020 Mar 27;9(4):923. doi:10.3390/jcm9040923Oxford University Hospitals.Information for People At-Risk for Post-Thrombotic Syndrome.Centers for Disease Control and Prevention.What is venous thromboembolism?Palacios FS, Rathbun SW.Medical treatment for postthrombotic syndrome.Semin Intervent Radiol. 2017;34(1):61-67. doi:10.1055/s-0036-1597765Cazaubon M.Deep vein thrombosis and air travel: Risk management in 2015.Phlebolymphology. 2015; 22(85):25-32.
Kahn SR.The post-thrombotic syndrome.Hematology Am Soc Hematol Educ Program. 2016;2016(1):413-418. doi:10.1182/asheducation-2016.1.413
Rabinovich A, Kahn SR.How I treat the postthrombotic syndrome.Blood. 2018;131(20):2215-2222. doi:10.1182/blood-2018-01-785956
Makedonov I, Kahn SR, Galanaud JP.Prevention and management of the post-thrombotic syndrome.J Clin Med. 2020 Mar 27;9(4):923. doi:10.3390/jcm9040923
Oxford University Hospitals.Information for People At-Risk for Post-Thrombotic Syndrome.
Centers for Disease Control and Prevention.What is venous thromboembolism?
Palacios FS, Rathbun SW.Medical treatment for postthrombotic syndrome.Semin Intervent Radiol. 2017;34(1):61-67. doi:10.1055/s-0036-1597765
Cazaubon M.Deep vein thrombosis and air travel: Risk management in 2015.Phlebolymphology. 2015; 22(85):25-32.
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