Post Thrombotic (Deep Vein Thrombosis) Prevention
Deep Vein Thrombosis (DVT) usually provokes an element of fear in most because it is known to carry the risk of blocking the blood vessels to the heart and causing death. This is known as Pulmonary Embolus (PE) and is the main reason for treating DVT as an emergency. Importantly, this is not the only risk, but it may lead to lifelong problems in the leg if not treated timeously and adequately. These problems include swelling, pain, skin changes and wound formation known as the “Post Thrombotic Syndrome’ or PTS.
Thus, early treatment of deep vein thrombosis is absolutely essential.
Post-thrombotic syndrome develops as a consequence of increased pressure in the veins from a residual clot or from the clot damaging the valves, causing back flow of blood.What are the symptoms of post thrombotic syndrome?
- Skin induration
- Ulceration (wound)
What can be done?
The best form of treatment is PREVENTION!
Post thrombotic syndrome may develop from 6 months after a deep vein thrombosis to years thereafter.
Thus, if one develops a deep vein thrombosis, one should seek help to try and prevent the leg ever getting to an advanced stage.
How does one do this?
- Scanning after 6 months to assess residual clot and valve function
- Compression stockings
- Lymphoedema treatment
We use a combined approach and a multidisciplinary team, involving education and preventative treatment.
What if the Post Thrombotic Syndrome has already developed?This is more difficult to treat, but patients may present with mild to severe symptoms.
- The vessels need to be assessed as to how blocked they are
- The valves need to be assessed as to whether they have been damaged or not
This can be done by duplex dopplers scanning and either a CT scan or an MRI scan.
Currently, surgical treatment options to open veins are growing. In some patient this can be done using balloons and stents (Vein Stenting). In some cases, open surgery needs to be done. This surgery is not easy and needs to be planned carefully.
Again, all patients will need compression and lymphatic drainage.