1. Post thrombotic Syndrome Godwin Tse LA-TRAP Winter 2011

2. What is post-thrombotic syndrome? Long-term complication of deep venous thrombosis (DVT) that is characterized by chronic, persistent pain, swelling and other signs in the affected limb Caused by damage to veins and valves

3. Signs and Symptoms Symptoms Heaviness Pain Swelling Itching Cramps Aching Symptoms worsen with activity and standing Signs Edema Eczema Hyperpigmentation Redness Secondary varicose veins Lipodermatoschlerosis (LDS) Venous Ulcers

6. DVT Post thombotic syndrome

7. Risk factors Age >65 Sex Location of DVT Recurrent DVT Lack of long-term anticoagulation Obesity

8. Prevention DVT Prophylaxis Optimal duration of anticoagulation After initial DVT: Prevention of recurrent DVT Compression stockings

9. Treatment Compression stockings/pump Elevation of extremity while resting Lifestyle changes Medications

10. PTS vs recurrent DVT Over 24h span (DVT): Dramatic onset of pain Persistent swelling Duplex ultrasound ▫May difficult to distinguish due to abnormalities still present in the venous segment

11. Social impact Costs ▫Increased medical costs ▫Lost of productivity at work/home Decreased quality of life

12. References http://www.stoptheclot.org/natt_publications/post_thrombotic_sy ndrome.pdfhttp://www.stoptheclot.org/natt_publications/post_thrombotic_sy ndrome.pdf http://www.venousdiseasecoalition.org/diseaseinfo/pts/ http://www.ncbi.nlm.nih.gov/pubmed/12163001 http://dermatology.cdlib.org/143/case_presentations/postthrombo tic_syndrome/vereecken.htmlhttp://dermatology.cdlib.org/143/case_presentations/postthrombo tic_syndrome/vereecken.html http://www.inate.org/en/1/2/6/23/default.aspx#Whatispostthrom boticsymdromehttp://www.inate.org/en/1/2/6/23/default.aspx#Whatispostthrom boticsymdrome http://emedicine.medscape.com/article/461449-overview http://www.fvleiden.org/ask/82.html http://circ.ahajournals.org/cgi/content/full/121/8/e217