Post-thrombotic syndrome medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Medical Therapy

Treatment options for PTS include proper leg elevation, compression therapy with elastic stockings or electrostimulation devices, herbal remedies (such as horse chestnut, rutosides, pentoxifylline), and wound care for leg ulcers.[1]

Compression bandages are useful to treat edemas. Stimulation medical devices such as Veinoplus can also reduce the symptoms of PTS. By stimulating the calf muscle pump, this device helps to remove venous stasis, to inhibit venous reflux and increases venous outflow.[2][3] Thus, lowers limbs are better irrigated.

Upper-Extremity Post-Thrombotic Syndrome

Patients with upper-extremity DVT may develop upper-extremity PTS, but the incidence is lower than that for lower-extremity PTS (15-25%).[4][5] There are no established treatment or prevention methods, but patients with upper-extremity PTS may wear a compression sleeve for persistent symptoms.

References

  1. Vazquez SR, Freeman A, VanWoerkom RC, Rondina MT. Contemporary issues in the prevention and management of postthrombotic syndrome. Ann Pharmacother 2009; 43:1824-35.
  2. Soriano C., Moll S., Deal A. Efficacy and optimal use of a portable electrical muscle stimulator (Veinoplus) to improve symptoms of post-thrombotic syndrome. Poster presented at the Annual scientific Symposium 2010 of the Hemophilia and Thrombosis Research Society (HTRS). Abstract, page 30, published by HTRS
  3. Nicolaides AN, Griffin M, Bond D et all. The Efficacy of New Veinoplus Stimulation Technology to Increase Venous Flow and Prevent Venous Stasis. Journal of Vascular Surgery. Volume 51, issue 3, page 790, March 2010
  4. Elman EE, Kahn SR. The post-thrombotic syndrome after upper extremity deep venous thrombosis in adults: a systematic review. Thromb Res 2006;117:609-14.
  5. Prandoni P, Bernardi E, Marchiori A, et al. The long-term clinical course of acute deep vein thrombosis of the arm: prospective cohort study. BMJ 2004; 329:484-5.