Tag Archives: Venous Ulcer

Chronic Venous Insufficiency and Post-thrombotic Syndrome (PTS)

Every year,large number of people suffer from acute Deep Vein Thrombosis (DVT; blood clots in a vein). Many of them, later on, develop symptoms affecting their legs. Chronic complications of DVT affecting legs is called “Post-thrombotic Syndrome” (PTS).

Venous blood is normally being pushed through healthy vein to the heart but in cases of PTS when veins are blocked with old or fresh clots the blood is “sitting” in the veins increasing venous pressure (high blood pressure in the veins). This has long-term consequences on the leg resulting in skin pigmentation, skin hardening, eczema, inflammation, and ultimately a skin defect or ulcer which are difficult to heal. Some DVT sufferers can’t walk, have chronic swelling and many people spend hours getting their ulcers re-dressed by their GPs. We also know that even if the ulcer heals eventually it often reoccurs and this can happen in up to 70% of people.

The DVT itself is also major issue as the clot can travel up to the lungs and can cause a permanent damage or death.

In order to prevent complications after DVT we recommend (for suitable candidates) urgent appointment (within days) with vascular specialist to discuss an intervention that can help avoid PTS. The idea is to remove the clot early so it does not cause vein damage and allow the blood to return back to heart. It also can prevent recurrent DVT which happens more often to those who already had one before.

Part of every assessment is a scan (ultrasound or CT – “cat scan”). Treatment traditionally only consisted of wearing elastic compression hosiery (bandages or stockings) but this was not optimal management as the veins remained untreated. Technology has advanced during last 5-10 years therefore we have new safe treatment options available. Most patients can be treated with keyhole surgery (“through a needle” ) and usually only under local anaesthetics. There are number of techniques that can be used to improve quality of life and in many cases it helps to get rid of elastic stockings for good.

Results of such mini invasive treatment are very encouraging and it is now more then ever before obvious that these interventions improve quality of life of people with acute and chronic Deep Vein Thrombosis.