Treatment for Post-Thrombotic Syndrome (PTS)

Post-thrombotic syndrome (PTS) is a condition caused by damage to veins from a blood clot. PTS can cause chronic pain, swelling, and other symptoms in your leg. It may develop in the weeks or months after a deep vein thrombosis (DVT) of the leg. DVT is a common condition, especially in people older than 65. Post-thrombotic syndrome affects a large number of people who have had DVT. It can happen in men and women of any age.

Types of treatment

Compression is the main treatment for post-thrombotic syndrome. This helps to increase the blood flow in the veins, and ease your symptoms.

You may be given prescription-grade compression stockings. These apply more pressure than the type you can buy over the counter. These are worn during the day, on the leg that had the DVT. You also may also be given an intermittent pneumatic compression (IPC) device. This device applies pressure on the veins of your leg.

Proper skin care is also key. You healthcare provider may tell you to use a product to lubricate your skin, such as petroleum jelly. Barrier creams that contain zinc oxide can also be helpful. You may need a steroid cream or ointment to treat your skin. If you develop leg sores (pressure injuries), they may need special treatment.

In some cases, your healthcare provider may advise surgery. This can be done to remove a blockage in a major vein. It can also be done to repair the valves in your leg veins.

Living with post-thrombotic syndrome

Symptoms often get better with treatment, but your symptoms may not all go away. It may help if you:

  • Walk every day

  • Do daily ankle flexing exercises

  • Raise your legs for a period of time, several times a day

Possible complications of post-thrombotic syndrome

Post-thrombotic syndrome can cause leg sores. If so, you will need to have wound care. Aspirin and a medicine called pentoxifylline may help aid healing of pressure injuries. If a pressure injury becomes infected, you may need antibiotics. Severe pressure injuries that don't get better with medicines and wound care therapy may need surgery to remove the damaged tissue.

Preventing post-thrombotic syndrome

You can reduce your risk for post-thrombotic syndrome by lowering your risk for DVT. Not moving or walking for long periods of time raises your risk for DVT. If you are immobile because of a health condition or surgery, your healthcare provider will tell you how to prevent DVT. This may include:

  • Taking blood-thinner medicine, such as warfarin

  • Using compression stockings

  • Using a compression device

  • Moving and walking as soon as you are able

Treating DVT right away is the best way to prevent post-thrombotic syndrome. Take blood-thinner medicine exactly as prescribed. Don't miss any follow-up tests to check your blood levels of the medicine. Use your compression devices exactly as prescribed.

When to call the healthcare provider

Call your healthcare provider right away if you have any of these:

  • A sore on your leg that is warm, red, or leaks fluid

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Symptoms of DVT, such as swelling, pain, or warmth in your leg