Prevention and treatment of post-deep vein thrombosis (PTS) of the lower extremities

  After a venous thrombosis of the lower extremity, the deep veins are occluded because of the thrombosis. Venous blood from the lower extremities can only return through the superficial veins. As a result, the normally invisible superficial veins dilate to meet the need for increased blood flow. This “bruise” cannot be treated surgically, as it is currently the only pathway for blood return.  Warfarin should still be continued for six months. Wear compression stockings consistently. You can take some drugs to improve the circulation, such as: Diosmin tablets, abortifacient and so on. Pay attention to the combination of work and rest, do not stand for a long time, or sit for a long time. You should move properly and elevate your lower limbs more.  What will develop in the future and what should I do?  A significant portion of deep vein thrombosis will gradually recanalize with time, that is, the deep vein will recanalize. This time can be short or long, from one or two months to several years. After the recanalization, the venous blood will go back to the “old way”. The superficial veins will be less “burdened”.  However, it is important to note that the direction of blood flow in the recanalized deep veins will be disturbed due to the destruction of the valve structure in the veins by the thrombus: in the upright or sitting position, when the limbs are sagging, the venous blood will flow to the lowest calves and feet due to gravity, which is often referred to as “backflow” by doctors (normal people will not experience this condition due to the existence of the venous valves), resulting in the lower legs. In some patients, the superficial varicose veins are further aggravated by the backflow of blood, and the skin is even darkened and ulcerated. The treatment of PTS is recognized as one of the most difficult problems in vascular surgery and there are few options, therefore, PTS is mainly prevented.  The main means of preventing PTS is to wear compression stockings, which must be habitual and adhered to in order to avoid, to the greatest extent possible, venous hypertension in the foot and lower leg and to slow down the appearance of PTS.