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The post-thrombotic syndrome: a 2012 therapeutic update
Jean-Philippe Galanaud1, Susan R Kahn
1Department of Internal Medicine, Montpellier University Hospital and EA 2992, Montpellier 1 University, Montpellier, France, jp-galanaud@chu-montpellier.fr.
Current Treatment Options in Cardiovascular Medicine
|January 18, 2013
Summary
Preventing deep-vein thrombosis (DVT) and post-thrombotic syndrome (PTS) is key. Early ambulation and compression stockings are recommended after DVT, alongside patient education for managing chronic venous insufficiency.
Area of Science:
- Vascular Medicine
- Thrombosis Research
- Patient Management
Background:
- Post-thrombotic syndrome (PTS) is a chronic, burdensome complication of deep-vein thrombosis (DVT).
- Limited therapeutic options exist, emphasizing prevention.
- Low adherence to thromboprophylaxis in hospital inpatients necessitates improved strategies.
Purpose of the Study:
- To outline optimal strategies for preventing DVT and subsequent PTS.
- To provide recommendations for managing established PTS.
- To evaluate current and emerging treatment modalities for PTS.
Main Methods:
- Review of current guidelines and evidence for DVT and PTS prevention.
- Recommendations for early ambulation and graduated elastic compression stockings (ECS) post-DVT.
- Discussion of patient education, compliance enhancement, and advanced therapies.
Main Results:
- Multi-component approaches, including automatic reminders, can improve DVT prophylaxis adherence.
- Early ambulation and two-year use of 30-40 mmHg below-knee ECS are recommended post-proximal DVT.
- Patient education, exercise programs, and higher-strength ECS can manage established PTS symptoms.
Conclusions:
- Preventing DVT and PTS requires improved prophylaxis adherence and consistent post-DVT management.
- Compression therapy and patient education are cornerstones for managing established PTS.
- Advanced interventions like catheter-directed thrombolysis and surgery require further evaluation for general use.
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