What is the treatment for the chronic phase of DVT in the lower extremities? In the chronic phase, not only anticoagulant drugs are used to dissolve the thrombus, but also a number of other complementary treatments, which are divided into two main parts: compression therapy and treatment to improve venous vasoreactivity. Compression therapy means wearing compression stockings, choosing thigh-length medical grade II compression stockings, which can effectively treat the problem of swollen legs. It also reduces the probability of after-effects. Since blood clots have an effect on the venous valves, improving venous vasoreactivity means enhancing the elasticity of the venous blood vessels through medications to reduce the damage to the valves and increase the return of blood to the veins. Commonly used are Mai Zhi Ling, Diosmin, Calcium Hydroxybenzene Sulfonate, and Ablixan-M. In addition, you can also use some Chinese patent medicines which are effective in restoring the venous return function and reducing the after-effects. Will anticoagulants in turn dislodge the thrombus? Taking anticoagulants to dissolve the thrombus, the people are worried that the thrombus is “melted open”, is not easier to fall off? In fact, the so-called thrombolysis refers to the action of drugs to the molecular level of the thrombus, so that the thrombus from the internal gradual disintegration, and not a large piece of a large piece of falling off. Once the acute phase is over, the thrombus is no longer at risk, so there is no need to worry. Will the chronic phase affect my daily activities and will there be any after-effects? We are all concerned about the after-effects of DVT. In fact, there is a term – post-thrombotic syndrome, which is similar to a cerebral infarction, where the blood vessels in the brain are blocked, and there will be after-effects such as hemiplegia, slurred speech, and so on. Then when the deep veins of the lower limbs are blocked, post-thrombotic syndrome is formed. As the deep veins of the lower limbs are blocked by thrombus, the metabolic waste of the lower limbs, toxins will be accumulated in the legs, day after day, stimulating the lower limbs swollen, itchy, blackened skin, easy to break, and ultimately the formation of “old legs”. Therefore, in order to avoid the emergence of post-thrombotic syndrome, the acute and chronic treatment must be standardized and thorough. Can I stop taking the medicine after the pain subsides? For lower extremity deep vein thrombosis, the minimum duration of adequate quantity and course of treatment is three months. Evidence-based medical evidence from abroad shows that prolonged anticoagulation therapy has a great effect on the recovery of thrombosis and the prevention of recurrence. Therefore, it is not the case that the drug can be stopped immediately when the symptoms disappear. Then when can the drug be stopped? Three months is a minimum period, if the patient cooperates with the extended anticoagulation therapy, according to the patient’s review results – D-dimer level and lower extremity vascular ultrasound, if the venous thrombus has been opened, then the treatment can be reduced or discontinued after 3 to 6 months of treatment. Since anticoagulants do not work when they are reduced in dosage, anticoagulants should either be continued or discontinued. Drugs that improve venous activity can be appropriately considered for dosage reduction until they are discontinued. What are the postural activity requirements in the chronic phase and how are they different from the acute phase? In the acute phase, the thrombus may dislodge and cause a pulmonary embolism, so absolute bed rest is required for 7 to 10 days. In the chronic phase, the thrombus is basically more stable, so it is possible to go down to the ground and do daily walking and jogging. When the patient enters the chronic stage, the intensity of activities should be decided according to the level of D-dimer. For example, if the D-dimer has been reduced to normal, the thrombus has been stabilized, and the ultrasound shows that the deep vein has been partially recanalized, then the patient can wear compression stockings to carry out daily life and sports exercises. How long should I wear compression stockings? There is no clear regulation on how long the stockings should be worn, but according to clinical experience, it is usually worn for at least one year, which is good for preventing after-effects and recurrence. Will standing for a long time aggravate the condition and how long can I stand? Standing for a long time will aggravate the swelling of the leg, but it is usually not a problem to stand continuously for less than half an hour. Teachers and store assistants, in particular, should generally stand for half an hour and then sit down to rest or do some kicking. Is the pain and swelling of the leg recurring in the chronic phase, and after the recurrence, is it time to go to the hospital again? It is not necessarily a recurrence of leg swelling in the chronic phase. Standing for too long and walking too much can cause leg swelling before the blood clot is completely opened. However, sudden pain is not a good sign. If you have pain and swelling, you should go to the hospital as soon as possible to check if you have had a relapse. There are only two tests that can be done to determine if a clot has returned: a D-dimer level in the coagulation panel and an ultrasound of the deep veins of the lower extremities. What should patients with DVT be aware of? Lower extremity deep vein thrombosis is a very common disease in clinical practice. It is divided into acute, subacute and chronic stages, and each stage has different treatment programs and principles. For the acute stage, we have to stabilize the thrombus with strict bed rest and early anticoagulation; for the chronic stage, we have to insist on standardized anticoagulation, and at the same time, we can combine with venous active medication, medical compression stockings, and thrombolytic therapy of traditional Chinese medicine, so as to let the thrombus open to the maximum extent without leaving any after-effects. Treatment of thrombus is a long-lasting war, at least three months or more, so patients should remember three points: treatment needs to be as early as possible, sufficient amount, and sufficient course of treatment.