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Learning About Post-Thrombotic Syndrome (PTS)

Leg veins, with detail of healthy vein and valve and of damaged vein that allows blood to leak backward

What is post-thrombotic syndrome (PTS)?

Post-thrombotic syndrome (PTS) is a problem that can happen after you've had a deep vein blood clot, called deep vein thrombosis (DVT). After a while, this blood clot (usually in your leg) can cause the pressure in your vein to rise. This pressure can damage the vein. PTS is also called post-phlebitic syndrome.

Veins have valves that keep the blood moving in one direction—toward the heart. With PTS, the valves in a damaged vein may not work well. Some blood may leak backward through the valve. PTS can cause long-term problems such as swelling, skin damage, and painful sores (venous skin ulcers) near the ankle.

PTS can be a long-term problem that lasts for years.

What are the symptoms?

When you have PTS, you may have discomfort, pain, sores, and swelling in your leg. Your skin may darken or have a brownish colour. The skin may be itchy and dry, and it may peel.

How is it diagnosed?

Your doctor will probably be able to diagnose PTS from your medical history, your symptoms, and a physical exam. You might have an ultrasound test so your doctor can check blood flow in your veins.

How is it treated?

You may wear specially fitted compression stockings to treat PTS. Your doctor may also discuss wearing an intermittent pneumatic compression device. It inflates and deflates knee-high boots. These stockings and devices help move the blood in your legs. They may help with pain and swelling.

Propping up your leg may reduce pain and swelling.

Exercise may help relieve PTS symptoms. Your doctor might suggest strength training for your legs. Aerobic exercise, such as walking, can also help. Talk with your doctor before you start a new exercise program.

For people who have severe symptoms, surgery or a catheter procedure might be done to restore blood flow. But these procedures aren't done often.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

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