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Post Thrombotic Syndrome

Long term effects from blood clots can cause complications known as PTS. Learn what you can do prevent post thrombotic syndrome.


Post Thrombotic Syndrome (PTS):

Knowledge. Exercise. Diet. Prevention Therapy.

What is it?

"PTS" occurs in a small number of individuals who suffer from DVT (Deep Vein Thrombosis) and VTE (Venous Thromboembolism). A person who suffers through multiple blood clots, may develop PTS due to a couple of factors, including, but not limited to; the damage done to their veins, calcified clot formations, reduced function in the limb(s), and/or decreased blood flow throughout the body.

Post thrombotic syndrome is a chronic but preventable condition that leads to limb pain, swelling, skin discolouration and ulceration, and rash after deep vein thrombosis (DVT). These signs and symptoms are seen at 10 years’ follow-up in up to 56% of patients who have had DVT.
~ Source:

Statistics Statistics

A little more than 50% of all DVT patients suffer from PTS (Post Thrombotic Syndrome). Up to 60,000 patients are hospitalized each year for DVT in Canada. Which leaves to conclude between: 25,000 – 35,000 Canadian DVT patients suffer from PTS within a 10-year period after their initial blood clot.

(Data collected from multiple sources)

Approximately 60% of patients with DVT will recover without any residual symptoms, ~30% will have some degree of PTS, and ~5‐10% will develop severe PTS.  Of note, ~15% of patients with upper extremity DVT also develop PTS. It is not possible to reliably predict which DVT patients will develop PTS.”
~ Source: Thrombosis Canada™

DVT occurs in about 200,000 Canadians every year.
~ Source:

Studies have reported a wide variability in the 10-year cumulative incidence of PTS after an acute DVT event, ranging between 20–100%. Estimates of the 2-year cumulative incidence of PTS also vary enormously, ranging between 23–60%. The estimated cumulative incidence of severe PTS after approximately 5-years, is in the range of 1–30%, although estimates of around 10% are more common.
~ Source:

81 patients (33%) developed PTS within 4.9 years. If they spent more than 50% of their time beneath an INR level of 2.0, then they were at higher risk of developing PTS.”
~ Source: Journal of Thrombosis and Haemostasis

Signs and Symptoms Signs & Symptoms

The signs and symptoms of PTS, Post Thrombotic Syndrome is unique in nature since involves pre-requirements such as having suffered through a DVT, Deep Vein Thrombosis and a length of time treating the effects of the DVT(s).

Typical Symptoms (Legs):

• Chronic swelling
• Chronic pain
• Restless leg syndrome
• Muscle aches and pains
• Leg(s) feels heavy
• Leg(s) feels tired
• Cramping in the leg(s)
• Nerve pain, spikes of pain
• Post Thrombotic pigmentation (blood dots reddish/purple)
• Varicose veins
• Foot/Toe swelling
• Burning sensations

Other Symptoms (Skin):

• Small bruises in lower limbs
• Dryness of the skin
• Hardening of skin tissue
• Venous skin ulcers
• Chronic ulcers (LV)
• Livedoid Vasculopathy
• White atrophy
• Discolouration of lower limbs


Post Thrombotic Syndrome has a cause & effect. The cause – DVT, the effect – years of trauma. Your legs are never the same after suffering through a deep vein thrombosis. Your veins have been stretched, bruised and battered from the traumatic event of a blood clot.

The Key is Prevention (Proactive), not just Treatment Afterwards (Reactive):

PTS occurs after years of dealing with DVT, so many measures need to be taken in order to prevent PTS from developing. Prevention is the key.

I have had PTS for many years. My specialists have tried many different strategies to heal my chronic ulcers, and to repair the damaged veins with little-to-no luck. Not because we didn’t have options, but because for me, it had been far too long while dealing with multiple DVT in both legs before I became proactive with my treatments.

~ Source: Martin R. Lemieux, Founder

Anticoagulant Therapy:

Unique to blood clot sufferers, clots cause a lot of damage internally creating higher risks of developing Post Thrombotic Syndrome. Blood clot patients who are prone to clotting must maintain a healthy anticoagulant therapy the ensure further damage is not an option. Each DVT harms the veins ability to heal and to remain strong througout the day.

Leg Elevation:

As the walls of the veins weaken and interior valves no longer perform as needed, blood starts to pool within the lower limbs causing a great deal of swelling and pain.

This 'pooling' of blood becomes stagnant affecting the surrounding areas. Throughout the day, legs become heavy, less flexible. This is why it's crucial that PTS sufferers elevate their legs above their heart multiple times a day. Once in the evening is not enough to help alieviate the swelling and pain.

Compression Stockings:

In the past, PTS was thought to be treated with compression stockings, but recent studies shows that compression therapy alone does not prevent long-term Post Thrombotic Syndrome from occurring. Compression therapy does on the other hand help with swelling and pain.

Compression stockings help to keep pressure in order to assist blood flow throughout the body. A patient must seek professional advice to ensure their compression is properly rated downward.

A Patient MUST be Sized Properly:

Although LEVEL-2 compression is crucial, it is not enough. A patient MUST have their lower limbs properly sized. Unlike diebetic socks, compression stockings need to be sized to fit the patient in order to have maximum affect. Failure to have uniquely fitted stockings may hinder the results drastically.

Stockings Must be Worn Throughout the Day:

Wearing compression stockings once or twice a week won't create the desired effect. The key is to wear them throughout the day to ensure a patient's blood flow is regulated, assisting them with every-day tasks. Compression stockings have come a long way in the past 20 years, a great deal of effort has been placed on comfort, durability and fashion.

Replacement Twice a Year:

Over time, compression stockings lose their elasticity over time. Patients are recommended to replace their stockings at least twice a year. As the compression softens, their usefulness becomes obsolete.

As a man, I had a hard time wearing my compression stockings in public, over time, this negligence caused a great deal of pain, discomfort and damage within my lower limbs. My one regret is that I didn't wear my prescribed stockings everyday to ensure a better future that allowed me to stand for longer periods of time.

~ Source: Martin R. Lemieux, Founder

The more a patient is involved immediately after suffering through a Deep Vein Thrombosis, the smaller the risks of that person developing Post Thrombotic Syndrome years later. The key is prevention therapy.

Medical Assistance Products:

Certain medical assistive products are now available to DVT sufferers worldwide and within Canada. Taking care of your legs after a DVT is crucial, even when the therapy doesn’t seem necessary.

VenoWave – Arterial Stimulation Therapy:

A new technology now being distributed among people suffering with DVT are small leg-massage units made from VenoWave. These small units attach behind the knee, at the calf area with easy to use straps. Once strapped to the leg, patients have the ability to set different massage therapies that they’re comfortable with.

The VenoWave system rolls onto a patient’s calf, massaging the calf with a smooth “wave” like motion.

The Venowave is Useful For:

• Compression
• Post Thrombotic Syndrome Prevention
• Management of the symptoms of Post Thrombotic Syndrome (PTS)
• Treatment of leg swelling due to vascular insufficiency
• Treatment of varicose veins
• Treatment of Chronic Venous Insufficiency (CVI)


I was given a pair of VenoWave units for my legs. I found them easy to use and not too noisy.”

~ Source: Anonymous Blood Clot Patient

Prevention and Risks Prevention & Risks:

So few blood clot survivors understand the risks of prolonged neglect of their bodies after traumatic events. Prevention is the key to helping to create a future that can be fufilling.

What are the risks?

• Feeling tired
• Hardened and iritated skin
• Inability to walk long distances
• Inability to run
• Livedoid vasculopathy
• Long-term disbility
• Loss of lower limbs
• Lymphedema
• Varicose veins
• Venous ulcers
• Weakened energy

Exercise is the Key:

Surviving a blood clot is only the beginning. Repairing the damage done internally begins with; knowledge, diet and exercise. A proper exercise regimen can help to rebuild the damage done to the affected veins and arteries. This is the key to preventing the long-term effects of post thrombotic syndrome.

Strength Training:

It is imperative that patients start with their strength training as soon as they are able. The stronger the muscles, the stronger the blood flow. Patients should seek out proper advice from rehabilitation centers to have a unique training schedule created for themselves.

Proper Exercise Daily:

As a person get's stronger, their pain and swelling subsides over time. Going for small walks daily prevents stiffness and flexibility problems. Here are some ideas to get started:

• Be active daily
• Don't over do it
• Know your strengths and weaknesses
• Go for walks daily
• Use proper exercise equipment
• Use exercise bands to increase flexibility
• Restorative yoga to increase blood flow

As you can see, there are many traditional and new age regiments a person can partake in daily to help the long-term effects of PTS. Seek out advice as much as possible and find the right fit for your healthcare needs.

Avoid Traumatic Events:

Patients who are on anticoagulants need to avoid traumatic events that puts their lives at risk. Partaking in sports events is not recommended. High impact sports poses a risk of internal bleeding and trauma to areas not recovered from previous clots.


Medical Note:

Any and all information provided here is not designed to give medical advice and/or replace recommendations from doctors.
Information therein comes from personal experiences of thrombosis patients.

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