Knowledge

Post-thrombotic syndrome

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must be performed to evaluate the situation: the degree of obstruction by clots, the location of these clots, and the detection of deep and/or superficial venous insufficiency. Since signs and symptoms of DVT and PTS may be quite similar, a diagnosis of PTS should be delayed for 3–6 months after DVT
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Treatment of PTS adds significantly to the cost of treating DVT. The annual health care cost of PTS in the United States has been estimated at $ 200 million, with costs over $ 3800 per patient in the first year alone, and increasing with disease severity. PTS also causes lost work productivity:
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Despite outgoing research, the cause of PTS is not entirely clear. Inflammation is thought to play a role as well as damage to the venous valves from the thrombus itself. This valvular incompetence combined with persistent venous obstruction from thrombus increases the pressure in veins and
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Patients with upper-extremity DVT may develop upper-extremity PTS, but the incidence is lower than that for lower-extremity PTS (15–25%). No treatment or prevention methods are established, but patients with upper-extremity PTS may wear a compression sleeve for persistent symptoms.
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Prevention of PTS begins with prevention of initial and recurrent DVT. For people hospitalized at high-risk of DVT, prevention methods may include early ambulation, use of compression stockings or electrostimulation devices, and/or anticoagulant medications. Elastic
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Treatment options for PTS include proper leg elevation, compression therapy with elastic stockings, or electrostimulation devices, pharmacotherapy (pentoxifylline), herbal remedies (such as horse chestnut, rutosides), and wound care for leg ulcers.
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Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW (June 2008). "Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)".
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Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)"
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capillaries. Venous hypertension induces a rupture of small superficial veins, subcutaneous hemorrhage and an increase of tissue permeability. That is manifested by pain, swelling, discoloration, and even ulceration.
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Bergqvist D, Jendteg S, Johansen L, Persson U, Odegaard K (March 1997). "Cost of long-term complications of deep venous thrombosis of the lower extremities: an analysis of a defined patient population in Sweden".
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These signs and symptoms may vary among patients and over time. With PTS, these symptoms typically are worse after walking or standing for long periods of time and improve with resting or elevating the leg.
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Defining the true efficacy of elastic compression stockings for PTS prevention (and if effective, elucidating the minimum compression strength necessary and the optimal timing and duration of compression
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A second prevention approach may be weight loss for those who are overweight or obese. Increased weight can put more stress and pressure on leg veins, and can predispose patients to developing PTS.
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Ageno W, Piantanida E, Dentali F, Steidl L, Mera V, Squizzato A, et al. (February 2003). "Body mass index is associated with the development of the post-thrombotic syndrome".
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Fully defining the pathophysiology of PTS, including the role of inflammation and residual thrombus after completion of an appropriate duration of anticoagulant therapy
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Prandoni P, Lensing AW, Cogo A, Cuppini S, Villalta S, Carta M, et al. (July 1996). "The long-term clinical course of acute deep venous thrombosis".
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PTS can affect 23 to 60% of patients in the two years following DVT of the leg. Of those, 10% may go on to develop severe PTS, involving venous ulcers.
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PTS lowers a person's quality of life after DVT, specifically with regards to physical and psychological symptoms and limitations in daily activities.
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When physicians find a DVT in the clinical history of their patients, a postthrombotic syndrome is possible if the patients have suggestive symptoms.
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Elman EE, Kahn SR (2006). "The post-thrombotic syndrome after upper extremity deep venous thrombosis in adults: a systematic review".
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Shbaklo H, Holcroft CA, Kahn SR (March 2009). "Levels of inflammatory markers and the development of the post-thrombotic syndrome".
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For people who have already had a single DVT event, the best way to prevent a second DVT is appropriate anticoagulation therapy.
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Kahn SR, Hirsch A, Shrier I. Effect of postthrombotic syndrome on health-related quality of life after deep venous thrombosis"
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Additional treatment options for PTS with demonstrated safety and efficacy (compression and pharmacologic therapies)
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The field of PTS still holds many unanswered questions that are important targets for more research. Those include:
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Roumen-Klappe EM, Janssen MC, Van Rossum J, Holewijn S, Van Bokhoven MM, Kaasjager K, et al. (April 2009).
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Appelen D, van Loo E, Prins MH, Neumann MH, Kolbach DN (September 2017). Cochrane Vascular Group (ed.).
757:"Relation between quality of anticoagulant treatment and the development of the postthrombotic syndrome" 678:"Predictors of the post-thrombotic syndrome during long-term treatment of proximal deep vein thrombosis" 507:
Pirard D, Bellens B, Vereecken P (March 2008). "The post-thrombotic syndrome - a condition to prevent".
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Vedantham S (2009). "Valvular dysfunction and venous obstruction in the post-thrombotic syndrome".
348:"The influence of venous thromboembolism on quality of life and severity of chronic venous disease" 1107:"The long term clinical course of acute deep vein thrombosis of the arm: prospective cohort study" 1105:
Prandoni P, Bernardi E, Marchiori A, Lensing AW, Prins MH, Villalta S, et al. (August 2004).
389:"Determinants of health-related quality of life during the 2 years following deep vein thrombosis" 158:
poor quality of anticoagulation control (i.e. dose too low) during the first 3 months of treatment
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Increasingly, catheter-directed thrombolysis has been employed. This is a procedure in which
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Caprini JA, Botteman MF, Stephens JM, Nadipelli V, Ewing MM, Brandt S, et al. (2003).
567:"Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombosis" 79: 387:
Kahn SR, Shbaklo H, Lamping DL, Holcroft CA, Shrier I, Miron MJ, et al. (July 2008).
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Kahn SR, Kearon C, Julian JA, Mackinnon B, Kovacs MJ, Wells P, et al. (April 2005).
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Shbaklo H, Kahn SR (September 2008). "Long-term prognosis after deep venous thrombosis".
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The benefits of compression bandages is unclear. They may be useful to treat edemas.
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van Dongen CJ, Prandoni P, Frulla M, Marchiori A, Prins MH, Hutten BA (May 2005).
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Whether PTS prevention methods are necessary for patients with asymptomatic, or
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Kahn SR, M'Lan CE, Lamping DL, Kurz X, BĂ©rard A, Abenhaim L (December 2004).
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people with severe PTS and venous ulcers lose up to 2 work days per year.
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Tick LW, Kramer MH, Rosendaal FR, Faber WR, Doggen CJ (December 2008).
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is a medical condition that may occur as a long-term complication of
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Residual symptoms following thrombosis (clots in the blood vessels)
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Vazquez SR, Freeman A, VanWoerkom RC, Rondina MT (November 2009).
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Kahn SR, Partsch H, Vedantham S, Prandoni P, Kearon C (May 2009).
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Masuda EM, Kessler DM, Kistner RL, Eklof B, Sato DT (July 1998).
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may reduce the occurrence of PTS after clinically confirmed DVT.
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a second DVT in same leg as first DVT (recurrent ipsilateral DVT)
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Role of thrombolytic ("clot-busting") drugs in PTS prevention
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The following factors increase the risk of developing PTS:
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Diseases of veins, lymphatic vessels and lymph nodes
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persistent DVT symptoms 1 month after DVT diagnosis
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Person with post-thrombotic syndrome and leg ulcers
90:Signs and symptoms of PTS in the leg may include: 192:will break up a clot using a variety of methods. 2122: 33:postphlebitic syndrome, venous stress disorder 1350: 795: 1156: 961:The Cochrane Database of Systematic Reviews 640: 1930:Chronic cerebrospinal venous insufficiency 1357: 1343: 1152: 1150: 287: 285: 283: 281: 169:Ultrasonography for deep venous thrombosis 38: 1223: 1182: 1130: 1069: 1046: 1002: 1000: 980: 895: 854: 813: 772: 693: 582: 533: 480: 404: 363: 309: 715: 713: 1262:10.7326/0003-4819-126-6-199703150-00006 1147: 620:10.7326/0003-4819-125-1-199607010-00001 278: 2123: 1163:Journal of Thrombosis and Thrombolysis 997: 830: 251:Developing a PTS risk prediction model 239: 230: 109:brownish or reddish skin discoloration 1702:Hereditary hemorrhagic telangiectasia 1338: 1157:Ashrani AA, Heit JA (November 2009). 928:(6 Suppl) (8th ed.): 381S–453S. 884:Journal of Thrombosis and Haemostasis 796:Kahn SR, Ginsberg JS (January 2004). 761:Journal of Thrombosis and Haemostasis 710: 682:Journal of Thrombosis and Haemostasis 571:Journal of Thrombosis and Haemostasis 502: 500: 469:Journal of Thrombosis and Haemostasis 393:Journal of Thrombosis and Haemostasis 352:Journal of Thrombosis and Haemostasis 294:"How I treat postthrombotic syndrome" 85: 1707:Generalized essential telangiectasia 291: 213: 13: 497: 14: 2147: 1280: 1857:Cerebral venous sinus thrombosis 1225:10.1046/j.1524-4733.2003.00204.x 897:10.1111/j.1538-7836.2009.03294.x 774:10.1111/j.1538-7836.2005.01333.x 695:10.1111/j.1538-7836.2005.01216.x 584:10.1111/j.1538-7836.2008.03180.x 538:. 123 Suppl 4 (Suppl 4): S62-5. 482:10.1111/j.1538-7836.2009.03286.x 406:10.1111/j.1538-7836.2008.03002.x 365:10.1111/j.1538-7836.2004.00957.x 1240: 1199: 1098: 1063: 1014: 948: 912: 871: 789: 748: 669: 634: 599: 222: 132: 1808:Hepatic veno-occlusive disease 1084:10.1016/j.thromres.2005.05.029 973:10.1002/14651858.CD004174.pub3 558: 527: 456: 421: 380: 339: 326: 1: 1620:Aneurysm of sinus of Valsalva 1474:Monckeberg's arteriosclerosis 1027:The Annals of Pharmacotherapy 856:10.1016/s0741-5214(98)70201-0 849:(1): 67–73, discussion 73–4. 802:Archives of Internal Medicine 643:Current Opinion in Hematology 544:10.1016/s0049-3848(09)70146-x 271: 175: 1925:Chronic venous insufficiency 1550:Aortoiliac occlusive disease 655:10.1097/moh.0b013e32830abde2 311:10.1182/blood-2009-07-199174 201: 162: 7: 1940:Inferior vena cava syndrome 1935:Superior vena cava syndrome 1662:Vertebral artery dissection 1652:Intracranial berry aneurysm 1250:Annals of Internal Medicine 1123:10.1136/bmj.38167.684444.3a 843:Journal of Vascular Surgery 608:Annals of Internal Medicine 10: 2152: 2041:Hypertensive heart disease 1692:Arteriovenous malformation 1667:Familial aortic dissection 722:Thrombosis and Haemostasis 509:Dermatology Online Journal 430:Thrombosis and Haemostasis 190:a vascular interventionist 2096: 2066:Renovascular hypertension 2031: 2022: 2009:Hepatic artery thrombosis 1957: 1917: 1872: 1776: 1758: 1749: 1717: 1677: 1657:Carotid artery dissection 1610:Abdominal aortic aneurysm 1582: 1542: 1519: 1460:Intermittent claudication 1430: 1423:Peripheral artery disease 1421: 1391: 1373: 1288: 1175:10.1007/s11239-009-0309-3 815:10.1001/archinte.164.1.17 292:Kahn SR (November 2009). 94:pain (aching or cramping) 51: 46: 37: 29: 24: 2051:Hypertensive nephropathy 1864:Post-thrombotic syndrome 1845:Paget–Schroetter disease 1637:Coronary artery aneurysm 1615:Thoracic aortic aneurysm 123: 64:Post-thrombotic syndrome 25:Post-thrombotic syndrome 2106:Orthostatic hypotension 2088:White coat hypertension 1565:Fibromuscular dysplasia 1529:Carotid artery stenosis 2078:Pulmonary hypertension 2061:Secondary hypertension 2056:Essential hypertension 2046:Hypertensive emergency 1887:Portacaval anastomosis 1823:Portal vein thrombosis 1465:Critical limb ischemia 1366:Cardiovascular disease 734:10.1055/s-0037-1613447 76:venous stress disorder 72:postphlebitic syndrome 2083:Systolic hypertension 1828:Renal vein thrombosis 1687:Arteriovenous fistula 1679:Vascular malformation 1647:Intracranial aneurysm 1534:Renal artery stenosis 934:10.1378/chest.08-0656 183:compression stockings 1997:Paradoxical embolism 1992:Cholesterol embolism 1818:May–Thurner syndrome 1813:Budd–Chiari syndrome 1796:Deep vein thrombosis 1791:primarily lower limb 1570:Raynaud's phenomenon 442:10.1160/TH08-08-0511 80:deep vein thrombosis 2073:Benign hypertension 1072:Thrombosis Research 1011:2008;133:454S-545S. 536:Thrombosis Research 240:Research directions 231:Society and culture 100:itching or tingling 1987:Pulmonary embolism 1897:Esophageal varices 1835:upper limb / torso 1479:Arteriolosclerosis 86:Signs and symptoms 2118: 2117: 2114: 2113: 1958:Arteries or veins 1953: 1952: 1778:Venous thrombosis 1745: 1744: 1727:Cherry hemangioma 1627:Aortic dissection 1578: 1577: 1413:Buerger's disease 1332: 1331: 1039:10.1345/aph.1m185 214:Upper extremities 61: 60: 19:Medical condition 2143: 2029: 2028: 1840:Mondor's disease 1783:Thrombophlebitis 1756: 1755: 1432:Arteriosclerosis 1428: 1427: 1389: 1388: 1359: 1352: 1345: 1336: 1335: 1286: 1285: 1274: 1273: 1244: 1238: 1237: 1227: 1203: 1197: 1196: 1186: 1154: 1145: 1144: 1134: 1102: 1096: 1095: 1067: 1061: 1060: 1050: 1018: 1012: 1004: 995: 994: 984: 952: 946: 945: 916: 910: 909: 899: 875: 869: 868: 858: 834: 828: 827: 817: 793: 787: 786: 776: 752: 746: 745: 717: 708: 707: 697: 673: 667: 666: 638: 632: 631: 603: 597: 596: 586: 562: 556: 555: 531: 525: 524: 504: 495: 494: 484: 460: 454: 453: 425: 419: 418: 408: 384: 378: 377: 367: 343: 337: 336:2002;162:1144-8. 330: 324: 323: 313: 289: 103:swelling (edema) 42: 22: 21: 2151: 2150: 2146: 2145: 2144: 2142: 2141: 2140: 2121: 2120: 2119: 2110: 2092: 2018: 1975:Microangiopathy 1970:Macroangiopathy 1949: 1913: 1882:Gastric varices 1868: 1781: 1772: 1741: 1713: 1673: 1605:Aortic aneurysm 1591: 1574: 1560:Erythromelalgia 1538: 1515: 1440:Atherosclerosis 1417: 1381: 1369: 1363: 1333: 1328: 1327: 1297: 1283: 1278: 1277: 1245: 1241: 1212:Value in Health 1204: 1200: 1155: 1148: 1117:(7464): 484–5. 1103: 1099: 1068: 1064: 1033:(11): 1824–35. 1019: 1015: 1005: 998: 953: 949: 917: 913: 876: 872: 835: 831: 794: 790: 753: 749: 718: 711: 674: 670: 639: 635: 604: 600: 577:(12): 2075–81. 563: 559: 532: 528: 505: 498: 461: 457: 426: 422: 385: 381: 358:(12): 2146–51. 344: 340: 334:Arch Intern Med 331: 327: 304:(21): 4624–31. 290: 279: 274: 242: 233: 225: 216: 204: 178: 165: 135: 126: 88: 70:), also called 20: 17: 12: 11: 5: 2149: 2139: 2138: 2133: 2116: 2115: 2112: 2111: 2109: 2108: 2102: 2100: 2094: 2093: 2091: 2090: 2085: 2080: 2075: 2070: 2069: 2068: 2058: 2053: 2048: 2043: 2037: 2035: 2026: 2024:Blood pressure 2020: 2019: 2017: 2016: 2011: 2006: 2001: 2000: 1999: 1994: 1989: 1979: 1978: 1977: 1972: 1961: 1959: 1955: 1954: 1951: 1950: 1948: 1947: 1942: 1937: 1932: 1927: 1921: 1919: 1915: 1914: 1912: 1911: 1906: 1905: 1904: 1899: 1894: 1884: 1878: 1876: 1874:Varicose veins 1870: 1869: 1867: 1866: 1861: 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1442: 1441: 1438: 1437: 1435: 1433: 1429: 1426: 1424: 1420: 1414: 1411: 1407: 1404: 1403: 1402: 1399: 1398: 1396: 1394: 1390: 1387: 1385: 1380: 1376: 1372: 1367: 1360: 1355: 1353: 1348: 1346: 1341: 1340: 1337: 1324: 1320: 1319: 1315: 1313: 1309: 1308: 1304: 1300: 1299: 1296: 1291: 1287: 1271: 1267: 1263: 1259: 1255: 1251: 1243: 1235: 1231: 1226: 1221: 1217: 1213: 1209: 1202: 1194: 1190: 1185: 1180: 1176: 1172: 1169:(4): 465–76. 1168: 1164: 1160: 1153: 1151: 1142: 1138: 1133: 1128: 1124: 1120: 1116: 1112: 1108: 1101: 1093: 1089: 1085: 1081: 1078:(6): 609–14. 1077: 1073: 1066: 1058: 1054: 1049: 1044: 1040: 1036: 1032: 1028: 1024: 1017: 1010: 1003: 1001: 992: 988: 983: 978: 974: 970: 966: 962: 958: 951: 943: 939: 935: 931: 927: 923: 915: 907: 903: 898: 893: 890:(5): 879–83. 889: 885: 881: 874: 866: 862: 857: 852: 848: 844: 840: 833: 825: 821: 816: 811: 807: 803: 799: 792: 784: 780: 775: 770: 767:(5): 939–42. 766: 762: 758: 751: 743: 739: 735: 731: 727: 723: 716: 714: 705: 701: 696: 691: 688:(4): 718–23. 687: 683: 679: 672: 664: 660: 656: 652: 648: 644: 637: 629: 625: 621: 617: 613: 609: 602: 594: 590: 585: 580: 576: 572: 568: 561: 553: 549: 545: 541: 537: 530: 522: 518: 514: 510: 503: 501: 492: 488: 483: 478: 474: 470: 466: 459: 451: 447: 443: 439: 436:(3): 505–12. 435: 431: 424: 416: 412: 407: 402: 398: 394: 390: 383: 375: 371: 366: 361: 357: 353: 349: 342: 335: 329: 321: 317: 312: 307: 303: 299: 295: 288: 286: 284: 282: 277: 266: 264: 260: 256: 253: 250: 247: 246: 245: 237: 228: 220: 211: 208: 199: 196: 193: 191: 186: 184: 173: 170: 157: 154: 151: 148: 146: 143: 140: 139: 138: 130: 121: 118: 111: 108: 105: 102: 99: 96: 93: 92: 91: 83: 81: 77: 73: 69: 65: 56: 54: 50: 45: 41: 36: 32: 28: 23: 2033:Hypertension 1945:Venous ulcer 1863: 1851: 1834: 1802: 1790: 1760:Inflammation 1641: 1600: 1489:Hyperplastic 1450:Fatty streak 1393:Inflammation 1316: 1301: 1256:(6): 454–7. 1253: 1249: 1242: 1218:(1): 59–74. 1215: 1211: 1201: 1166: 1162: 1114: 1110: 1100: 1075: 1071: 1065: 1030: 1026: 1016: 1008: 967:: CD004174. 964: 960: 950: 925: 921: 914: 887: 883: 873: 846: 842: 832: 808:(1): 17–26. 805: 801: 791: 764: 760: 750: 728:(2): 305–9. 725: 721: 685: 681: 671: 649:(5): 494–8. 646: 642: 636: 611: 607: 601: 574: 570: 560: 535: 529: 512: 508: 475:(4): 582–7. 472: 468: 458: 433: 429: 423: 396: 392: 382: 355: 351: 341: 333: 328: 301: 297: 243: 234: 226: 223:Epidemiology 217: 209: 205: 197: 194: 187: 179: 166: 145:proximal DVT 136: 133:Risk factors 127: 119: 115: 89: 75: 71: 67: 63: 62: 2098:Hypotension 1642:head / neck 1494:Cholesterol 1384:capillaries 141:age > 65 30:Other names 2125:Categories 2014:Vasculitis 2004:Thrombosis 1965:Angiopathy 1909:Varicocele 1902:Hemorrhoid 1732:Halo nevus 1588:dissection 1379:arterioles 614:(1): 1–7. 272:References 263:distal DVT 176:Prevention 57:Hematology 2136:Syndromes 1768:Phlebitis 1509:Trans fat 1445:Foam cell 1401:Arteritis 1368:(vessels) 515:(3): 13. 202:Treatment 163:Diagnosis 97:heaviness 53:Specialty 1982:Embolism 1584:Aneurysm 1521:Stenosis 1455:Atheroma 1406:Aortitis 1375:Arteries 1234:12535239 1193:19224134 1141:15256419 1092:16002126 1057:19737994 991:28950030 942:18574271 906:19175497 824:14718318 783:15869588 742:12574811 704:15733061 663:18695373 593:18983518 552:19303507 521:18627714 491:19175493 450:19277412 415:18466316 374:15613019 320:19741190 258:therapy) 1803:abdomen 1484:Hyaline 1323:D054070 1270:9072931 1184:4761436 1048:3245967 982:6483721 865:9685132 628:8644983 155:obesity 82:(DVT). 1268:  1232:  1191:  1181:  1139:  1132:515197 1129:  1090:  1055:  1045:  989:  979:  940:  904:  863:  822:  781:  740:  702:  661:  626:  591:  550:  519:  489:  448:  413:  372:  318:  1918:Other 1751:Veins 1601:torso 1543:Other 1312:I87.0 1009:Chest 922:Chest 298:Blood 124:Cause 112:ulcer 1852:head 1382:and 1318:MeSH 1266:PMID 1230:PMID 1189:PMID 1137:PMID 1088:PMID 1053:PMID 987:PMID 938:PMID 902:PMID 861:PMID 820:PMID 779:PMID 738:PMID 700:PMID 659:PMID 624:PMID 589:PMID 548:PMID 517:PMID 487:PMID 446:PMID 411:PMID 370:PMID 316:PMID 74:and 1499:LDL 1303:ICD 1258:doi 1254:126 1220:doi 1179:PMC 1171:doi 1127:PMC 1119:doi 1115:329 1111:BMJ 1080:doi 1076:117 1043:PMC 1035:doi 977:PMC 969:doi 930:doi 926:133 892:doi 851:doi 810:doi 806:164 769:doi 730:doi 690:doi 651:doi 616:doi 612:125 579:doi 540:doi 477:doi 438:doi 434:101 401:doi 360:doi 306:doi 302:114 68:PTS 2127:: 1603:: 1586:/ 1377:, 1321:: 1310:: 1307:10 1264:. 1252:. 1228:. 1214:. 1210:. 1187:. 1177:. 1167:28 1165:. 1161:. 1149:^ 1135:. 1125:. 1113:. 1109:. 1086:. 1074:. 1051:. 1041:. 1031:43 1029:. 1025:. 999:^ 985:. 975:. 963:. 959:. 936:. 924:. 900:. 886:. 882:. 859:. 847:28 845:. 841:. 818:. 804:. 800:. 777:. 763:. 759:. 736:. 726:89 724:. 712:^ 698:. 684:. 680:. 657:. 647:15 645:. 622:. 610:. 587:. 573:. 569:. 546:. 513:14 511:. 499:^ 485:. 471:. 467:. 444:. 432:. 409:. 395:. 391:. 368:. 354:. 350:. 314:. 300:. 296:. 280:^ 1780:/ 1590:/ 1358:e 1351:t 1344:v 1305:- 1295:D 1272:. 1260:: 1236:. 1222:: 1216:6 1195:. 1173:: 1143:. 1121:: 1094:. 1082:: 1059:. 1037:: 993:. 971:: 965:9 944:. 932:: 908:. 894:: 888:7 867:. 853:: 826:. 812:: 785:. 771:: 765:3 744:. 732:: 706:. 692:: 686:3 665:. 653:: 630:. 618:: 595:. 581:: 575:6 554:. 542:: 523:. 493:. 479:: 473:7 452:. 440:: 417:. 403:: 397:6 376:. 362:: 356:2 322:. 308:: 66:(

Index


Specialty
deep vein thrombosis
proximal DVT
Ultrasonography for deep venous thrombosis
compression stockings
a vascular interventionist
distal DVT




"How I treat postthrombotic syndrome"
doi
10.1182/blood-2009-07-199174
PMID
19741190
"The influence of venous thromboembolism on quality of life and severity of chronic venous disease"
doi
10.1111/j.1538-7836.2004.00957.x
PMID
15613019
"Determinants of health-related quality of life during the 2 years following deep vein thrombosis"
doi
10.1111/j.1538-7836.2008.03002.x
PMID
18466316
doi
10.1160/TH08-08-0511
PMID

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