Postthrombotic syndrome (PTS) is a chronic sequela of deep vein thrombosis presenting with persistent leg heaviness and swelling. First-line management targets these symptoms directly, with the primary goal of reducing edema and restoring comfort.
Reduce edema and improve PTS symptoms — specifically leg heaviness and swelling.
Management centres on a specific form of graduated external compression worn on a prescribed daily schedule, alongside a supervised physical conditioning programme for patients who are able to tolerate it.
DOI: 10.1007/s11239-015-1312-5
Prescribe 20–30 mm Hg ECS to patients with PTS-related leg heaviness or swelling.
We suggest knee-length ECS, which have similar physiologic effects to thigh-length ECS and are easier to apply, more comfortable and less costly.
Explain to the patient that these are to be worn daily, from waking to retiring.
We suggest that a supervised exercise training program consisting of leg strengthening and aerobic activity for 6 months or more is reasonable for PTS patients who can tolerate it.
We suggest the use of 20–30 mm Hg (or stronger, if ineffective) ECS to reduce edema and improve PTS symptoms.
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