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What Is Post Thrombotic Syndrome (PTS)?

Post-thrombotic syndrome is a severe medical complication resulting from a blood clot in the deep vein. There is no cure for PTS, so doctors advise at-risk patients to practice prevention. Like the ones we sell at Comrad, compression socks may help prevent deep vein blood clots or deep vein thrombosis (DVT). Studies suggest that wearing compression socks or stockings after DVT may help patients avoid post-thrombotic syndrome. 

Unfortunately, PTS is a potentially debilitating condition that impacts approximately 30 to 50 percent of patients with DVT. PTS symptoms include heaviness, itching, tingling, cramping, leg pain, swelling, hyperpigmentation, skin changes, distended veins, and leg ulcers. Of patients with deep venous thrombosis, 5 to 10 percent go on to develop severe PTS. Long-term side effects from PTS, such as chronic leg pain, can interfere with a patient's ability to work and participate in normal activities. 

People with PTS are also at greater risk for recurrent venous thromboembolism, including pulmonary embolism and additional incidents of DVT. Since pulmonary embolism can be fatal, preventing PTS could protect you from life-threatening medical problems. 

How Does PTS Develop?

To understand PTS, it is important to know how and why blood clots develop in the first place. Poor circulation, vascular problems, and abnormal blood coagulation can contribute to blockages in your blood vessels. A clot (thrombus) in the deep vein of the leg is particularly problematic. Even after receiving treatment for an initial DVT, some patients never fully clear a thrombus from the deep vein. 

Patients can continue to experience venous hypertension or increased pressure in the vein due to a residual thrombus or permanent vein damage. Inflammation and genetic predisposition may also play a role in how a patient recovers from DVT. 

Doctors diagnose PTS when the acute phase of DVT is over, but the symptoms of venous hypertension continue. The Villalta-Prandoni scale assists medical professionals as they evaluate the severity of ongoing PTS symptoms to diagnose the syndrome. Usually, a patient receives a PTS diagnosis between six months and two years after the initial treatment for the deep vein blood clot. 

How Does Compression Help?

First of all, compression therapy has been shown to reduce the risk factors for DVT in vulnerable groups, including pregnant women, airline passengers, and patients recovering from surgery. Compression socks improve your overall circulation by gently squeezing your veins, supporting your fragile venous valves and vein walls. 

This prevents stagnant blood, venous reflux, and valvular reflux. In particular, graduated compression (compression that exerts more pressure at the ankle) has improved blood flow velocity and supports vascular health. Since poor circulation and vascular problems contribute to DVT, knee-high compression socks offer an excellent preventative tool. If you never form a deep vein blood clot in the first place, you won't go on to develop post-thrombotic syndrome or pulmonary embolism.

After experiencing an initial DVT, you can continue to benefit from compression socks. A meta-analysis of the scientific literature determined that compression therapy reduced the incidence of post-thrombotic syndrome in patients with DVT, particularly severe post-thrombotic syndrome. 

In fact, some studies suggest that compression socks and stockings may reduce the rate of PTS within two years of proximal DVT by as much as 50 percent. Although more research is needed to determine the optimal compression strength and duration of use, compression socks offer a low-cost and straightforward preventative measure with few adverse effects. That's why doctors have looked to preventive compression therapy as the cornerstone of PTS treatment for decades.

Moreover, England's National Health Service recommends compression socks to manage the symptoms of PTS. Even after a patient receives a PTS diagnosis, compression socks can effectively improve quality of life and promote good circulation. Since PTS often causes recurrent DVT, doctors also recommend compression socks as a preventative treatment to reduce the risk of additional blood clots. 

Treatment of PTS

Since there is no cure for PTS, patients must manage symptoms and reduce their risk of recurrent clots. Cedars-Sinai, a medical nonprofit, describes compression therapy as the main treatment for PTS. In addition to compression, other treatment strategies include leg elevation, exercise, medication (thrombolysis and anticoagulants), and surgery. 

Most doctors advise patients with PTS to pay attention to pain, swelling, skin changes, or other symptoms in the lower limbs. Any sudden change could indicate an acute thrombus that needs immediate medical treatment. 

For patients with severe cases of PTS, excellent wound care is essential to prevent venous ulcers from becoming infected. There is evidence to suggest that graduated compression socks promote faster healing for venous ulcers. Research also suggests that graduated compression may help to prevent their recurrence. 

How Can Comrad Help?

Knee-length compression socks, like Comrad Companions, are more convenient than other forms of compression therapy. Unlike intermittent pneumatic compression devices, compression bandages, or thigh-high garments, our products don’t require complicated instructions. 

The compression level of our most popular socks, 15-25 mmHg, provides a versatile mild-to-medium range that's ideal for daily use. They exert more pressure at the ankle than most over-the-counter compression socks. We opted for the extra squeeze because research indicates that a higher compression strength is more effective in treating venous ulcers. 

For DVT patients who experience swelling in the affected limb, we offer extra-wide calf sizes (up to 20 inches in circumference). This helps ensure the perfect fit. Our socks also have padding in the toe and heel to promote a more comfortable experience throughout the day. Plus, our socks feature SmartSilver antimicrobial technology. 

That means that the fabric has silver ions bonded to the thread, which slows the growth of bacteria, mold, and fungus. Skin infections are common for patients with severe PTS, so cleanliness is important to promote good health. 

Don't let the symptoms of post-thrombotic syndrome slow you down. Wearing compression socks can help you at every stage of PTS—from prevention to pain management. Over time, your PTS socks are likely to become your favorite pair. 

After all, 99% of Comrad reviewers say they would recommend our socks to a friend. Traci B. explains why in her recent review: "These are the best out of all the compression socks I’ve tried. It’s not a struggle to get them on; they stay in place perfectly, no weird seams bother me, and the compression level is great, very soothing. Will be buying more for sure!" 


Below-knee elastic compression stockings to prevent the post-thrombotic syndrome: a randomized, controlled trial | Ann Intern Med.

Compression stockings after deep-vein thrombosis: Knee-highs or thigh-highs? | Harvard Health

Data and Statistics on Venous Thromboembolism | CDC

Graduated compression stockings | CMAJ

Information for people at risk of post-thrombotic syndrome | NHS

Post-Thrombotic Syndrome | Cedars Sinai

The post-thrombotic syndrome | Hematology Am Soc Hematol Educ Program

DVT and venous insufficiency | Vascular Society 

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