Your treatment plan

Post-thrombotic syndrome describes the long-term effects that can happen after a blood clot (called a deep vein thrombosis or DVT) in the legs.

Your appointment

You'll have an appointment in the venous clinic in the outpatients department at Gassiot House, St Thomas’ Hospital.

If you're having surgery, you might also need to come to a pre-assessment clinic on the same day. Please allow enough time for both appointments.

After your appointment

After your appointment in the venous clinic at St Thomas’ Hospital, we talk about your case in our multidisciplinary team meeting. Different members of medical staff are at this meeting, including:

• vein (vascular) doctors
• staff from the haematology service, which specialises in blood disorders
• staff from the interventional radiology service, which offers minimally invasive procedures using medical imaging guidance

We can then make sure that all aspects of your case are reviewed, because post-thrombotic syndrome is often a complex issue.

We refer most people for a review with the haematology team in the thrombosis clinic. If this is the case, they'll contact you for an appointment.

Treatment options

The following section lists possible treatment options for post-thrombotic syndrome. Sometimes, you might need a mixture of all these options.

All treatment options (surgical or non-surgical) have risks as well as benefits. These risks are specific to each person. We explain them to you before any decisions about your treatment are made.

Non-surgical (conservative) treatment

This includes managing your condition with:

• anticoagulant medicines, which stop the blood clotting as quickly as usual
• compression stockings
• exercise and keeping active

Compression stockings may help to manage some of the swelling, heaviness and pain. They help with the blood flow in your legs and back towards the heart (the venous return).

You can get compression stockings from the patient appliances department at Guy’s and St Thomas’ hospitals or on prescription from a GP. You need to replace them at least every 3 to 6 months, or if they become damaged and lose elasticity (when they do not return to their original position after stretching).

Endovascular procedure

This is a minimally invasive procedure, which is done in our hybrid theatre or interventional radiology department.

Other options

In some cases, you may need a more extensive surgical reconstruction procedure.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have a procedure or treatment, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

Read more about our consent process.

What happens if you do not have treatment

There's no cure for post-thrombotic syndrome. It's a long-term (chronic) condition. However, the aims of the recommended treatments are to:

• control or reduce symptoms
• reduce the risk of ulceration

Follow-up appointment

We'll give you a follow-up appointment. This is usually in the vascular outpatients department at Gassiot House, St Thomas’ Hospital. The appointment is with either:

• your vascular consultant
• a member of the venous team

If you have had venous surgery and have a stent (small tube to hold open weak or narrowed blood vessels), you'll need to have scans at regular intervals. This is to make sure that the stent stays open. You'll usually have your first scan after 2 weeks and see a healthcare professional in the outpatient clinic after about 6 weeks.

We recommend that you avoid:

• long-haul flights (more than 4 hours) during the week before your vein operation
• short-haul flights (less than 4 hours) for 2 weeks after surgery
• long-haul flights (more than 4 hours) for 4 weeks after surgery

Support and more information

Thrombosis UK

A charity that works to increase awareness, support and research to extend understanding. It offers medically approved information to improve care for all those affected by thrombosis.
Website: www.thrombosisuk.org