The post-thrombotic syndrome: A review

Objective: A review of the published data on epidemiology, pathophysiology, diagnostic techniques and prevention of the post-thrombotic syndrome (PTS). Study selection: Studies, published between 1966 and 1996, identified through the medline database, and references cited in identified articles were included. Data synthesis: Deep venous thrombosis (DVT) may cause outflow obstruction and valve incompetence, resulting in venous hypertension. PTS is probably the effect of venous hypertension on the microcirculation. For qualitative anatomical and functional assessment of the venous system, duplex scanning is required, and for quantitative functional assessment, plethysmographic methods are the most suitable. The best treatment of PTS is its prevention by optimizing diagnosis and treatment of DVT and by prescribing and wearing elastic compression stockings. Until valid follow-up studies have been performed, distal DVT should not be neglected when assessing the PTS risk. Conclusions: PTS is a serious problem in terms of prevalence, complications (venous ulcers) and treatment with considerable socio-economic consequences. Duplex and plethysmography are valuable tools in its diagnosis and might be appropriate to identify patients at risk of developing PTS.