A quick overview:
What is post-thrombotic syndrome?
The post-thrombotic syndrome is a chronic blood reflux congestion in which the venous system no longer functions properly. The first signs can occur weeks, months or even years after a survived deep vein thrombosis (DVT), for example a leg vein thrombosis.
Neither the course of a PTS nor the probability of contracting it can be predicted. But there are risk factors that promote the development of post-thrombotic syndrome (PTS).
The degrees of severity of the PTS are divided into four stages (Hach 1994), the spectrum of which extends from the tendency of the tissue to swell without hardening (stage I) to extensive ulcers (stage IV).
Causes and risk factors: How does PTS develop?
If the vein walls and/or vein valves were damaged by a deep vein thrombosis in the leg, scarring may have occurred. These can create conditions where the blood accumulates permanently and the tissue hardens.
The veins can be affected, for example, by the body's own defence cells and other substances during acute thrombosis. If the blood accumulates in a vein, the valves no longer close properly and the pressure in the surrounding vessels can rise. Due to the accumulated blood, liquid can escape into the tissue via the capillaries (tiniest vessels). If the oxygen supply is impeded by the swelling, wound healing disorders are likely in the case of injuries – up to chronic ulcers.
Risk factors for PTS
Risk factors for post-thrombotic syndrome generally exist in the elderly, smokers, overweight and people with venous (pre)diseases, for example varicose veins.
Other risk factors are:
- Thrombosis, either already survived or recurrent
- Surgeries and medications
- Inadequate treatment of thrombosis with anticoagulants
Signs and symptoms of post-thrombotic syndrome
Signs and symptoms of the PTS depend on the respective stage. The arterial circulation situation and the function of the ankle joint also play a decisive role: If the ankle joint is restricted in its movement, the vein-activating calf muscle pump fails. Tingling, itching, numbness, convulsions and varicose veins may be signs of symptoms of post-thrombotic syndrome.
Typical symptoms include:
- Leg heaviness
- Fatigue
- Swelling of the ankle and lower leg (oedema, thick leg)
- Lower leg pain
- Movement limitations
- Brown-reddish skin discolouration / pigmentation
- Rash
- In the further course: trophic disorders of the skin (dryness, dandruff, light spots, thin skin)
- Chronic wound healing disorder (venous leg ulcer)
Prevention: Is it possible to prevent post-thrombotic syndrome?
- Anticoagulant drugs are not only used in thrombosis therapy, but also for the prevention of further thromboses and of the post-thrombotic syndrome. After surviving a thrombosis, the patient is treated with blood thinner therapy for a few months, or possibly longer if certain risk factors are present. The physician regularly checks the coagulation values.
- Medical compression stockings use mechanical pressure to relieve the veins. The flow rate of the blood increases, the vein valves close again and the entire affected region is relieved. Patients with PTS can also make use of this functionality in consultation with their physician. Patients with vein disorders should wear their medical compression stockings daily.
How to treat post-thrombotic syndrome
Treatment and healing of the PTS can be a challenge, depending on the severity of the disease. The basic therapy consists of compression therapy, for example with medical compression stockings. Drug therapy can support treatment, but is not a substitute for compression therapy.
Further therapy measures for PTS
Treatment of PTS is in the hands of specialists such as angiologists (doctors specialising in the blood vessels), phlebologists (specialists in venous diseases) or vascular surgeons. If PTS is present with a leg ulcer, comprehensive care by a vascular centre and wound management are recommended.
Any patient suffering from post-thrombotic syndrome can take proactive measures to improve their situation:
- Avoid risk factors, such as by maintaining a healthy diet, losing weight or stopping smoking.
- Activate your calf muscle pump through decongestion gymnastics and movement, for example: Vein therapy gymnastics, climbing stairs, walking, cycling. Cold water applications (for example Kneipp pools) and water gymnastics are especially recommended.
- Take care of your skin: Protect your skin from drying out, injuries and inflammation and alleviated itching.
- Always make sure that you do not interrupt the blood flow in your legs: Do not fold your legs over each other when sitting down and – for example when gardening – only remain in a squatting or kneeling position for a short time, and also avoid trousers that are too tight.
medi products for post-thrombotic syndrome
Get advice from your doctor because: Which compression stocking is right for you depends on several factors. Among other products, various round knit models, as well as the mediven thrombexin 18, are available.
Diagnosis & treatment
Diagnosis & treatment
Product tip
Health personnel will make the diagnosis and can prescribe medical aids, e.g. from medi if necessary.
Your medical retailer will fit them individually for you.
