Postthrombotic Syndrome After Acute Deep Venous Thrombosis

The principal complications of deep venous thrombosis (DVT) are pulmonary embolism (PE) and postthrombotic syndrome (PTS). Despite receiving anticoagulant treatment, one third of patients with first proximal DVT experience PTS (Lancet 2005; 365:1163). PTS is characterized by pain, swelling, skin pigmentation, and, in severe cases (about 8% of patients), skin ulcerations. Why some patients develop PTS and others do not is unclear.

To identify features associated with PTS, Canadian investigators conducted a prospective, multicenter, cohort study of 387 patients with symptomatic DVT confirmed by venous duplex ultrasound (60% had proximal DVT; 15% had concurrent PE). Of DVT risk factors, obesity (body-mass index [BMI] ≥30 kg/m²) was observed in …