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Clinical Presentation of Post Thrombotic Syndrome - Leg pain and swelling treated at Vein Treatment Center in Buffalo Niagara and Southern Ontario, Canada
Monday, August 12, 2013



Post thrombotic syndrome is a chronic debilitating condition that develops in up to 50% of patients after deep vein thrombosis (DVT).  It is the most common complication of deep vein thrombosis.  Post thrombotic syndrome is costly and has significant sequelae in quality of life (QOL) indicators and in terms of detrimental economic value to the U.S. economy.


Residual venous obstruction after deep vein thrombosis in valvular venous insufficiency in the deep veins leads to increased venous pressure also known as venous hypertension.  Venous hypertension results in reduced calf muscle perfusion, increased tissue permeability and the associated clinical manifestations of post thrombotic syndrome.  Post thrombotic syndrome is associated with groupings of symptoms and clinical signs which may vary from individual to individual.  Patients with post thrombotic syndrome complain of pain and heaviness in the legs, swelling and cramping in the legs, itching or tingling in the affected lower extremity.  These signs and symptoms may be intermittent or persistent even in the supine (bedrest) position.


Clinical signs that may be found on physical examination include swelling, telangiectasias, hyperpigmentation, stasis dermatitis, varicose veins and in severe cases, lipodermatosclerosis and venous stasis ulceration.


In general patients with proximal DVT of the lower extremity, 60% will have no residual symptoms and 30% will develop some degree of postthrombotic syndrome.  5% of patients or one in 20 patients will have severe post thrombotic syndrome.


Symptoms of post thrombotic syndrome usually begin within the first six months after DVT but can occur up to two years after the development of deep vein thrombosis.


For more information about post thrombotic syndrome, contact Dr. Karamanoukian for a free copy of this book called Post Thrombotic Syndrome or go to and request a free copy.


For treatment of post thrombotic syndrome in the Buffalo Niagara region and Southern Ontario contact Hratch Karamanoukian, MD FACS at the Vein Treatment Center with offices in Williamsville, New York and Clarence, New York or call 716-839-3638 or go to or and are partners with .



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