Long-term prognosis after deep venous thrombosis.

PURPOSE OF REVIEW: Deep vein thrombosis (DVT) is associated with significant long-term complications such as the postthrombotic syndrome (PTS). The present review focuses on the risk determinants of PTS after DVT, means to treat and prevent PTS, and the impact of PTS on patients and society. Knowledge acquired during the last decade is presented, with emphasis on reports published in the past 2 years.

RECENT FINDINGS: PTS occurs in 20-50% of patients within 1-2 years after DVT. The principal risk factor for PTS identified to date is recurrent ipsilateral DVT; obesity and poor quality of anticoagulation for the treatment of DVT also appear to play a role. Although treatment options for established PTS are limited, a new battery-operated lower limb venous return assist device was recently shown in a randomized trial to reduce symptoms and signs in patients with severe PTS. Daily use of compression stockings after DVT appears to reduce the risk of PTS, and early use may be better than the later use.

SUMMARY: Further studies of clinical determinants and biological markers of increased risk of PTS as well as testing of preventive and therapeutic modalities for PTS are needed to ultimately improve long-term prognosis after DVT.