A simple strategy to prevent post thrombotic syndrome?

By Vania Morelli
Researcher at TREC

The formation of a venous blood clot in the deep veins of the body is a common condition in the general population that is associated with a serious complication known as “post thrombotic syndrome”. Currently, there is no cure for the post thrombotic syndrome; therefore, prevention of this complication is very important. A recent study from the Netherlands presents a promising and simple strategy to prevent the post thrombotic syndrome based on compression therapy applied to the legs.

Post thrombotic syndrome can affect up to 50% of patients during the first two years after the development of blood clots in the deep veins of the legs. Patients generally experience pain, heaviness, swelling and itching in the affected leg. In the most severe cases, leg ulcers can also occur, which are chronic, painful, and slow to heal. Post thrombotic syndrome can substantially impair the quality of life and ability to work and has become a major challenge to health care systems.

Researchers in the Netherlands have recently conducted a study to investigate the potential of an early compression therapy applied to the legs, either in the form of multilayer compression bandaging or compression hosiery, to prevent post thrombotic syndrome in patients with venous blood clot. The study involved 592 adult patients with blood clots in the deep veins of the legs from ten medical centers across the Netherlands. According to the medical protocol followed by each of the participating centers, one group of patients received no compression therapy, whereas the other group received compression therapy starting within 24 hours after the diagnosis of the clot. The compression therapy was applied until the resolution of the swelling of the affected leg. Additionally, all patients received “blood thinners” for a period of at least three months, which is the therapy generally recommended for the treatment of venous blood clot.

After an average follow-up of 5 months, an ultrasound of the deep veins of the legs was performed in all patients in order to search for residual clots. The researchers found that the proportion of patients who still had residual clots was lower in the group who received compression therapy (46%) compared to those who did not receive this therapy (67%). Moreover, patients without residual clots developed less post thrombotic syndrome during a follow-up period of two years. The researchers concluded that the application of immediate compression therapy might decrease the risk of residual clots and consequently the occurrence of post thrombotic syndrome.

If the findings of the present study are confirmed by future investigation, compression therapy applied shortly after the diagnosis of blood clots in the deep vein of the legs has the potential to be a simple and effective strategy to reduce the burden of the post thrombotic syndrome.

Reference: Amin EE, Bistervels IM, Meijer K, Tick LW, Middeldorp S, Mostard G, van de Poel M, Serné EH, Otten HM, Klappe EM, Joore MA, Ten Cate H, Ten Wolde M, Ten Cate-Hoek AJ. Residual vein occlusion in relation to immediate compression and postthrombotic syndrome in deep vein thrombosis. Blood 2018.

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