Surviving DVT
Blood-thinning drugs are very effective in preventing growth and migration of blood clots (1). Less than 1 in 20 DVT patients who are receiving blood-thinning drugs develop a PE, and less than 1 in 100 patients develop a fatal PE. Medical DVT treatment offers some inconveniences to patients (outpatient heparin therapy is given by once-daily or twice-daily injections and patients on warfarin must have their blood taken regularly to make sure the level is correct), but patients can be reasonably confident that they will not suffer a life-threatening event if properly treated.

Unfortunately, despite the use of blood-thinning drugs, 25-50% of DVT patients will develop the Post-Thrombotic Syndrome (PTS) (2-4), a long-term condition that causes daily pain, heaviness, fatigue, and swelling of the leg. Because PTS symptoms are aggravated by standing or walking, patients are often forced to alter their daily activities to include periods of rest or leg elevation. In the more severe cases, PTS can lead to an inability to walk without pain, inability to hold a steady job or perform household duties, changes in leg skin color and texture, and/or open sores (leg ulcers). As a result, PTS significantly reduces quality of life (QOL) in DVT patients (5-7).

1. Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Ed). Chest 2008; 133:454S-545S.

2. Prandoni P, Lensing AW, Prins MH, et al. Below-knee elastic compression stockings to prevent the post-thrombotic syndrome. Ann Intern Medicine 2004; 141: 249-256.

3. Brandjes DP, Buller HR, Heijboer, H, et al. Randomized trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet 1997; 349:759-762.

4. Prandoni P, Lensing A, Cogo A, et al. The long term clinical course of acute deep venous thrombosis. Ann Intern Med 1996; 125:1-7.

5. Kahn SR, Ducruet T, Lamping DL, et al. Prospective evaluation of health-related quality of life in patients with deep venous thrombosis. Arch Intern Med 2005; 165:1173-1178.

6. Kahn SR, Hirsch A, Shrier I. Effect of postthrombotic syndrome on health-related quality of life after deep venous thrombosis. Arch Intern Med 2002; 162:1144-1148.

7. Kahn SR, Shbaklo H, Lamping DL, et al. Determinants of health-related quality of life during the 2 years following deep vein thrombosis. J Thromb Haemost 2008; (6(7):1105-1112.