Thrombotic Syndrome After Blood Clots: Triggers, Signs, and Remedies
Post-thrombotic syndrome (PTS) is a common complication that can develop following a deep vein thrombosis (DVT), affecting around 20-50% of patients within 1-2 years after the initial diagnosis[1][2]. This condition results from damage to venous valves and persistent venous hypertension, leading to chronic venous insufficiency.
Symptoms of PTS
PTS can cause a range of symptoms, including chronic leg pain, heaviness, and fatigue that worsen throughout the day. Persistent leg swelling, especially after activity or standing, is also common. Skin changes such as discoloration (brown-red spots), thickening, and loss of elasticity (lipodermatosclerosis) can occur. Severe itching and eczema-like rashes, venous ulcers, which are painful skin sores that can take months or years to heal in advanced cases, are other potential symptoms[1][2][5].
Risk Factors for Developing PTS
Certain factors may increase a person's chances of developing PTS, including being over 65, having obesity, getting DVT above the knee, having symptoms of a blood clot one month after doctors diagnose it, not taking blood thinner medication such as warfarin once doctors diagnose DVT, and having more than one blood clot in the same vein more than once[1].
Treatment and Management of PTS
Treatment for PTS focuses on symptom relief and preventing progression, as there is no cure for established PTS. Compression therapy, using graduated compression stockings, is the mainstay treatment to reduce venous hypertension and alleviate symptoms like swelling and pain[1][2]. Early and appropriate anticoagulant therapy during DVT helps prevent valve damage and significantly reduces the risk of PTS developing[1].
For certain patients with recent large DVTs, catheter-directed thrombolysis (clot-busting therapy) can dissolve clots rapidly to restore blood flow and potentially reduce PTS risk[4]. In advanced or severe cases, venous ulcers may require specialized wound care and possibly surgical interventions[2].
Prevention of PTS
Prevention of PTS by prompt, effective treatment of the initial DVT remains more effective than treating PTS once it is established[1]. To reduce the risk of developing PTS, a person should lower their risk of developing DVT by staying active, avoiding long periods of sitting, taking blood-thinning medication if recommended, avoiding smoking, maintaining a moderate BMI, and seeking treatment for DVT symptoms.
References
- Post-thrombotic syndrome occurs due to venous valve damage and hypertension, causing pain, swelling, skin changes, and ulcers[1][2].
- Compression therapy and anticoagulation are key treatments; catheter-directed thrombolysis is an option for some recent, large clots[1][2][4].
- PTS has no cure but can be managed symptomatically and prevented by early DVT treatment[1].
- Currently, no FDA-approved medications or supplements are available to treat PTS.
- There are no tests available for diagnosing PTS, but doctors use a scoring system called the Villalta score to diagnose and categorize the severity of PTS.
- Deep vein thrombosis (DVT) is a condition where blood clots form in a person's deep veins, usually in the leg.
- A person should contact their doctor if they experience symptoms of DVT or an ulcer on the affected leg, such as pain, itching, swelling, discolored or hardened skin, a foul-smelling discharge, leg heaviness, or a tickling or prickling sensation.
[1] Mayo Clinic. (2021). Post-thrombotic syndrome. https://www.mayoclinic.org/diseases-conditions/post-thrombotic-syndrome/symptoms-causes/syc-20355381
[2] National Heart, Lung, and Blood Institute. (2021). Deep Vein Thrombosis (DVT) and Pulmonary Embolism. https://www.nhlbi.nih.gov/health-topics/deep-vein-thrombosis-dvt-and-pulmonary-embolism
[3] American Heart Association. (2021). Post-thrombotic syndrome. https://www.heart.org/en/health-topics/stroke/complications/post-thrombotic-syndrome
[4] American College of Chest Physicians. (2012). Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. https://www.ncbi.nlm.nih.gov/books/NBK92755/
[5] National Institute for Health and Care Excellence. (2019). Deep vein thrombosis and pulmonary embolism in over 16s: diagnosis and management. https://www.nice.org.uk/guidance/cg144/chapter/1-Recommendations#postthrombotic-syndrome
- In addition to post-thrombotic syndrome (PTS), chronic kidney disease, cancer, respiratory conditions, and various skin conditions can be chronic medical conditions that require medical attention.
- The science of medical-conditions such as PTS advances, leading to more effective treatments like compression therapy.
- Besides seeking help for PTS, one should also pay attention to cardiovascular health, physical therapy, and skin care for maintaining overall health and wellness.
- It's important to remember that while PTS might not have a cure, chronic diseases like cancer and chronic kidney disease also require ongoing management and treatment.
- In the pursuit of good skin care, individuals should be mindful of addressing skin conditions like discoloration, thickening, or loss of elasticity, which might be symptoms of PTS.
- In the unfortunate event of developing an ulcer or experiencing symptoms of deep vein thrombosis, prompt consultation with a healthcare professional can lead to early diagnosis and potentially prevent the progression to PTS or more severe health complications.
