Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
Imperial Vascular Unit, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.
Expert Rev Cardiovasc Ther. 2021 Mar;19(3):191-200. doi: 10.1080/14779072.2021.1876563. Epub 2021 Jan 26.
: Post-thrombotic syndrome (PTS) is a common lifelong condition affecting up to 50% of those suffering from deep vein thrombosis (DVT). PTS compromises function and quality of life with subsequent venous ulceration in up to 29% of those affected.: A literature review of surgical and non-surgical approaches in the prevention and treatment of PTS was undertaken. Notable areas include the use of percutaneous endovenous interventions and the use of graduated compression stockings (GCS) after acute proximal DVT.: In patients with acute iliofemoral DVT, we think it is important to have a frank conversation with the patient about catheter-directed thrombolysis, aiming to reduce the severity of PTS experienced. We advocate ultrasound-accelerated thrombolysis with adjunctive procedures, such as deep venous stenting for proximal iliofemoral DVT. For patients with isolated femoral DVT, we believe that anticoagulation and GCS should be recommended. In patients with established PTS, we recommend GCS for symptomatic relief. We recommend that patients engage in regular exercise where possible with the prospect of gaining symptomatic relief. For those with severe PTS that has a significant effect on quality of life, we discuss the patient's case at a multi-disciplinary team meeting to plan for endovenous intervention.
: 血栓后综合征（PTS）是一种常见的终身疾病，影响多达 50%的深静脉血栓形成（DVT）患者。PTS 会影响功能和生活质量，随后受影响的患者中有多达 29%会出现静脉溃疡。: 对预防和治疗 PTS 的手术和非手术方法进行了文献回顾。值得注意的领域包括经皮静脉内介入的使用和急性近端 DVT 后使用分级加压弹力袜（GCS）。: 在急性髂股 DVT 患者中，我们认为与患者进行关于导管定向溶栓的坦诚对话很重要，旨在减轻所经历的 PTS 的严重程度。我们提倡使用超声加速溶栓，并辅以近端髂股 DVT 的深静脉支架置入等介入治疗。对于孤立性股 DVT 患者，我们认为应推荐抗凝和 GCS。对于已确诊的 PTS 患者，我们建议使用 GCS 缓解症状。我们建议患者尽可能进行常规运动，以期获得症状缓解。对于那些 PTS 严重且对生活质量有重大影响的患者，我们会在多学科团队会议上讨论患者的病例，以计划进行静脉内介入治疗。
