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As our discussions for DVT Awareness Month continue, Dr. Philip T. Zeni leads our Q&A today.  Dr. Zeni will examine some of the long term complications of DVT and its management.  

If I don't get my DVT treatment what can I expect in the long term?

In 25 to 60% of patients with DVT, valvular damage can occur resulting in a post thrombotic syndrome (PTS). PTS is characterized by chronic pain, swelling, skin discoloration and even skin ulceration.  The symptoms usually occur within the first two years after the initial DVT and unfortunately often persist for the remainder of the patient's life.

How will I be evaluated?

Sonography (Ultrasound) of the lower limbs is the best test to evaluate for residual clot and degree of collateral flow

And if treatment is needed what could be done?

Post thrombotic syndrome is difficult to treat. The best treatment is the prevention of DVT. If the clot has formed and there are symptoms of PTS, catheter directed thrombolysis (CDT) of the DVT may be undertaken in certain cases.  However, usually the only treatment options are compression stockings, elevation and anticoagulation.

Does this type of treatment work?

In patients with post thrombotic syndrome (PTS) DVT catheter directed thrombolysis (CDT) can result in significant improvement of symptoms. However, returning the limb to normal is unlikely.

If I don't want anything invasive what can I do?

The non-invasive treatment of PTS includes compression stockings, elevation and anticoagulation. These treatments also will improve symptoms but not reverse the valvular damage.

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