What is postthrombotic syndrome and how is it treated in venous thromboembolism (VTE)?

Updated: Nov 05, 2020
  • Author: Vera A De Palo, MD, MBA, FCCP; Chief Editor: Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS  more...
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The most common long-term complication of treated DVT is postthrombotic syndrome (postphlebitic syndrome), which is a chronic complication of VTE characterized by pain and swelling. [57]  Chronic deep venous insufficiency, recurrent cellulitis, venous stasis, and ulceration of the skin can develop in as many as 50% of patients treated with full anticoagulation.

The results from an open-label, randomized, controlled trial suggested that additional treatment with catheter-directed thrombolysis using alteplase (an rt-PA) reduces the development of postthrombotic syndrome, prompting the authors to suggest that it be considered for patients at low risk of bleeding who have high proximal DVT. [58]

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