What are Treatment Options for Post-Thrombotic Syndrome?

Post-thrombotic syndrome (PTS) is a common complication that strikes patients who have had a deep vein thrombosis (DVT). PTS affects as many as 20-50 percent of DVT patients, and symptoms may not appear until years after a DVT. It causes leg pain, swelling, heaviness, itching or tingling, and discoloration, which may also lead to diminished quality of life1, 2. If untreated, the blood clot present with DVT can cause inflammation and damage to the valves which allow the blood to return to the heart. The obstruction and/or damaged valves ultimately diminish circulation and if left untreated, can eventually lead to more severe complications, such as venous ulcers. A venous ulcer is an open, shallow wound that appears on the lower leg, just above the ankle and below the calf. It is these ulcers that make treatment of PTS so vital. Venous ulcers are time-consuming and costly to treat, consuming approximately 2% of healthcare spending in the United States. Because a large percentage of PTS patients develop complications, early diagnosis and treatment is imperative. Traditional Treatments Typically, compression stockings are the first step in the care pathway3. They offer varying levels of support and should be fitted by a healthcare professional3. They are worn during the day and may be removed at night. Patients are generally placed on anticoagulation therapy (blood thinners) to prevent the recurrence of clots. Endovascular Therapy Unfortunately, PTS patients may have an obstruction of one or more of the major veins returning blood to the heart. If this is the case, balloon angioplasty and venous stents are required to open the veins and allow adequate flow of the blood. Venous stenting is minimally invasive and safe, providing significant relief from symptoms4. This procedure has provided physicians with an alternative to bypass surgery, which is open surgery and produced results no better than angioplasty and stenting. For patients whose disease has progressed to the stage of venous... Read more

What is Postthrombotic Syndrome?

Affecting up to 20-50 percent of people who experience complications from deep vein thrombosis (DVT)1, Postthrombotic Syndrome (PTS) can have a major effect on an individual’s daily productivity. The syndrome’s presentation, symptoms, causes and treatment options are described as follows. Description of Syndrome Most commonly observed in the legs, PTS is defined as a group of symptoms that occur following a diagnosis of deep vein thrombosis (DVT), or the presence of a blood clot in a vein not located at the superficial surface of the body. Anti-coagulation drugs, walking regimens and compression therapies can help to manage DVTs, but in situations where these methods are not fully effective, PTS may develop and necessitate further interventions2. Associated Symptoms The symptoms of postthrombotic syndrome are often more pronounced when a patient is in motion, and less pronounced when a patient is at rest or with the affected limb in an elevated position. Appearance wise, these symptoms may present as one or more of the following: red or brown pigmentation of the skin, swelling of the limb, venous leg ulcers, thickening of limb tissue and varicose veins. The patient may experience physical symptoms such as cramping or more intense pain, tingling, itching and a feeling of heaviness. Related Causes DVT is the preliminary condition associated with PTS. Those who are diagnosed with the former condition are thought to have a greater chance of developing the latter condition if several factors are present. These include venous hypertension, damage or inflammation of the venous valves and a recurrence of deep-vein thrombosis in the same limb where the first occurrence was found. Studies have examined several additional factors that can put people at elevated risk for developing PTS. Obesity, advanced age, thrombosis of the iliac or femoral vein, persistent recurrence of symptoms within one month of a deep vein thrombosis diagnosis, the presence of certain biomarkers and blood clotting disorders are included among these factors3.... Read more

What is a Venous Ulcer?

Venous ulcers are the most common type of ulcers affecting lower extremities, accounting for about 80% of all lower extremity ulcerations. Approximately 1% of people in the United States suffer from venous ulcers1. A venous ulcer is a shallow wound that appears on the lower leg, just above the ankle and below the calf when veins do a poor job of returning blood back up to the heart. They can be either small or large, but are not a perfect circle. These ulcers are generally wet all the time, and one may experience drainage2. What is the cause of Venous Ulcers? In a healthy circulatory system, the heart pushes oxygen-rich blood from the lungs through arteries to the furthest reaches of the body. Veins carry oxygen-poor blood and waste products away from the body cells to protect tissues and organs from dangerous toxins. When blood is not properly returned to the heart, a condition known as venous insufficiency can develop.  This can be caused by either an obstruction and/or reflux3. An obstruction can be due to a clot or compression on the vein.  The most common type of compression is May-Thurner Syndrome, where an artery crushes a vein reducing blood flow. Gravity helps arteries move blood from the heart down to the feet, but that downward gravitational pull makes it more difficult for veins to move blood back up to the heart. To prevent blood from flowing backwards, veins have small valves that trap blood in between heartbeats. Reflux occurs when the valves begin to weaken and can no longer prevent blood from flowing backward. Venous insufficiency is the underlying cause of these ulcers as it causes blood to pool in the lower limbs.  Blood can seep out of veins and into surrounding tissue. Eventually, the tissue begins to break down and a skin ulcer appears.2 What are the Symptoms? Discolored skin, usually dark red or purple, is often... Read more

What is May-Thurner Syndrome?

May Thurner Syndrome (MTS) is when the right iliac artery crosses and compresses the left iliac vein. This is also known as iliocaval compressions syndrome, Cockett Syndrome, or iliac vein compression syndrome.  MTS is commonly undiagnosed.  This condition has been seen in approximately 20% of the population1; and is predominant in females from the ages of 20-402. What are the complications associated with May-Thurner Syndrome? A person with MTS can have the following symptons2: Lower leg pain and swelling Skin pigmentation changes in the lower leg Chronic leg pain Recurrent skin ulcers around the ankle Varicose Veins Deep Vein Thrombosis (DVT) – a blood clot How is May-Thurner Syndrome Treated? MTS will be treated only when there are symptoms.  The initial treatment is based on what the symptoms are.  If a clot is present, it will be treated first. Then, the compression caused by MTS is treated with a stent.”.  The treatment options to address the clot are anticoagulation and catheter-directed thrombolytic therapy.  Anticoagulation therapy features blood-thinning medications that prevent blood clots. Thrombolytic therapy is a minimally invasive procedure where a physician directs the tip of a long, slender catheter tube through the affected vein to the segment where the blood clot is located. He then delivers clot-dissolving drugs, known as thrombolytics, through the catheter and into the clot. The clot typically dissolves quickly, usually in just a few hours or in a couple of days3. MTS can then be directly treated through the use of angioplasty and stenting. Angioplastyis a minimally invasive procedure where the physician inserts a catheter with a small deflated balloon attached to the tip. The catheter is fed through to the part of the vein that needs to be treated. Once there, the balloon is inflated to stretch the vein open and increase blood flow. The vein doctor then deflates and removes the balloon from the treated vein.  After removing the balloon catheter, the doctor... Read more

I’ve Had a Deep Vein Thrombosis, What Should I be Worried About?

Suffering a deep vein thrombosis (DVT) can be a very scary thing. This disorder occurs when a blood clot forms in a vein (a vessel which returns blood to the heart) deep within the body, usually in the pelvis or legs. The estimate of the annual incidence of DVT is over 3.5 million cases worldwide1. Each one can be a serious threat to a patient’s health. Link to Pulmonary Embolism A majority of these thromboses develop in the legs. Although many cause swelling, pain, increased warmth in the area of swelling and discoloration; some have no signs or symptoms. DVT is a serious condition. A patient with this disorder is at risk for blood clots forming and traveling to the lungs. A pulmonary embolism is a clot that blocks a blood vessel in the lungs. The warning signs of an embolism, which can be fatal, include2: Unexplained shortness of breath Pain with deep breathing Coughing up blood Postthrombotic Syndrome Postthrombotic Syndrome (PTS) is a common complication that strikes patients who have had a DVT. It also goes by the name postphlebitic syndrome.Postthrombotic syndrome, which affects as many as 20-50 percent of DVT patients, is the result of damage a blood clot does to veins when it cuts blood flow in the areas affected. One of the most dangerous aspects of this disorder is that sometime symptoms don’t appear until years after a DVT. 3,4 This painful disorder is actually an umbrella term for a collection of symptoms. The most common include5: Pain, aching and swelling in the leg Leg heaviness Leg itching or tingling Leg cramping An ulcer (sore) on the leg If you have suffered a DVT and are experiencing these symptoms, you should consult with your physician. Preventing Another DVT Up to 30% of patients who have a DVT are at risk for a second within ten years. Patients who have had recent hospitalization, surgery, cancer or... Read more
Page 3 of 41234