Strategies for the prevention and management of PTS
Strategies
.
Prevention
Prevent index DVT with the use of thromboprophylaxis in high-risk patients and settings as recommended in evidence-based consensus guidelines.
Prevent recurrent ipsilateral DVT by providing anticoagulation of appropriate intensity and duration for the initial DVT and by targeted use of appropriate thromboprophylaxis if long-term anticoagulation is discontinued.
Use of knee-length, 30- to 40-mm Hg ECS elastic compression stockings for up to 2 years after DVT; optimal duration uncertain.
The role of thrombolysis for the prevention of PTS is not yet established. Catheter-directed thrombolytic techniques require further evaluation in properly designed trials before being endorsed as effective and safe in reducing the risk of PTS.
Management
Elastic compression stockings reduce edema and improve PTS symptoms.
Intermittent pneumatic compression units and the VenoWave device are effective for severe symptomatic PTS.
Venoactive agents such as aescin (horse chestnut extract) or rutosides may offer short-term improvement of PTS symptoms; large controlled trials addressing long-term effectiveness and safety are needed.
Compression therapy, skin care, and topical dressings are primarily used to treat venous ulcers.
Providing patient support and ongoing follow-up is essential.
Strategies
.
Prevention
Prevent index DVT with the use of thromboprophylaxis in high-risk patients and settings as recommended in evidence-based consensus guidelines.
Prevent recurrent ipsilateral DVT by providing anticoagulation of appropriate intensity and duration for the initial DVT and by targeted use of appropriate thromboprophylaxis if long-term anticoagulation is discontinued.
Use of knee-length, 30- to 40-mm Hg ECS elastic compression stockings for up to 2 years after DVT; optimal duration uncertain.
The role of thrombolysis for the prevention of PTS is not yet established. Catheter-directed thrombolytic techniques require further evaluation in properly designed trials before being endorsed as effective and safe in reducing the risk of PTS.
Management
Elastic compression stockings reduce edema and improve PTS symptoms.
Intermittent pneumatic compression units and the VenoWave device are effective for severe symptomatic PTS.
Venoactive agents such as aescin (horse chestnut extract) or rutosides may offer short-term improvement of PTS symptoms; large controlled trials addressing long-term effectiveness and safety are needed.
Compression therapy, skin care, and topical dressings are primarily used to treat venous ulcers.
Providing patient support and ongoing follow-up is essential.