Understanding Management of Post Thrombotic Syndrome
PTS is characterized by chronic swelling, pain and skin thickening with pigmentation around the lower calf. Often, ulceration can occur on the inner aspect of the ankle and this can be very difficult to heal. The ulcer are often chronic and even when they are treated properly, they are prone to recur. Patients with long standing PTS may also have options that were previously not available. A careful evaluation with contrast venography and CAT scans may demonstrate chronic narrowing of major veins in the pelvis and abdomen. This situation is the result of scarring from a previous DVT. Symptomatic relief can occur if these obstructions can be opened up with angioplasty and stent techniques. Occasionally reconstructive surgery can be considered but each case is complex and requires careful evaluation before embarking on a course of treatment.