[Post-thrombotic venous disease of the legs. Current data]

The post-thrombotic syndrome (PTS) is the first cause of the severe chronic venous insufficiency (CVI) of which the total cost is very high. The lack of precise definitions, the long latency time between the deep vein thrombosis (DVT) and the trophic changes, the difficulties in treating the post-thrombotic ulcers, are partly responsible for the difficulties in analysing the problem of the PTS (epidemiology, pathophysiology, exploration) and consequently for the lack of interest in this disease. The recent data show that: 1) trophic venous changes are not all of PTS origin, 2) calf DVT are not to be neglected concerning the PTS risk, 3) the calf deep valvular destruction and the calf perforating veins reflux play the first part in the PTS evolution, 4) we should take into consideration the whole venous hemodynamic function of the lower limbs (macro and microcirculation) when analysing the long term clinical and hemodynamical consequences of a DVT. Today, the best treatment of a PTS is still its prevention not only by a better diagnosis and treatment of DVT but also by a long term ambulatory elastic stocking therapy with the aim of prolonging the disease-free interval.