This trial is evaluating whether Treatment will improve 19 secondary outcomes in patients with Postthrombotic Syndrome. Measurement will happen over the course of 9 months.
This trial requires 86 total participants across 2 different treatment groups
This trial involves 2 different treatments. Treatment is the primary treatment being studied. Participants will all receive the same treatment. Some patients will receive a placebo treatment. The treatments being tested are in Phase 3 and have had some early promising results.
Symptoms of PTS and a predisposition to arterial embolism can lead to an arterial thrombosis in the upper limb in patients at an increased risk of a thrombotic event. The risk of subsequent arterial events including TE in patients with PTS is very low. When embolisms and/or arterial thromboses occur, they must be treated medically.
Current clinical management of postthrombotic syndrome differs substantially between countries. This is an important insight for future treatment of the condition and may guide the development of treatment guidelines. Furthermore, the development of new treatment modalities may broaden the options for patients with PTS.
Postthrombotic syndrome affects approximately 1 in 2500 hospitalized patients. The incidence of postthrombotic syndrome is higher in women with an incidence of approximately 1% a year. The average length of stay is 9 days plus or minus 5 days. The number of complications with postthrombotic syndrome varies widely between patients.
We suggest that two factors, particularly an acute hypercoagulable state and a chronic thromboresis, are important factors for PTS. These factors seem to be associated with PTS.
Symptoms of postthrombotic syndrome are not always present in the initial days after an inferior venous thromboembolism. Only when symptoms are present do patients have a low probability of having underlying venous thromboembolism and may benefit from anticoagulation on their own.
The authors concluded that postthrombotic syndrome most commonly resolves spontaneously in a period of weeks to months and that some patients have persistent improvement for up to 4 decades. There was a trend toward a more favorable clinical result for patients with low initial symptoms or no symptoms.
PTPS, defined as chronic edema associated with new vascular lesions after deep vein thrombosis, occurs in about 8% of patients with DVT and usually resolves, with minimal treatment.
The [recent advances in treatment of DVT and PE (thromboembolism) have improved treatment outcomes dramatically in past decades. In conclusion, the use of warfarin in the first 12 weeks of therapeutic use to prevent postthrombotic syndrome (PTS) is highly recommended.
Postthrombotic syndrome is a multifactorial disease and can be of either autoimmune or nonautoimmune origin. The most common identifiable cause was autoimmune and more commonly associated with HLA-B51. The exact pathogenesis of postthrombotic syndrome remains unknown, but the underlying pathophysiology of this syndrome is associated with various factors such as an increased propensity for thrombosis, dysregulation of fibrinolysis and complement/immune system pathways, and an altered vascular wall and endothelial function. A multi-faceted approach to postthrombotic syndrome treatment should be investigated, including prophylactic anticoagulation and use of anti-inflammatory agents.
The most common side effects related to thrombectomy and antithrombotic therapy were [skin bruising or bleeding (4%), hematoma (3%), pain (3%), and swelling (3%)]. In a recent study, findings do not indicate a need to adjust thrombectomy and antithrombotic therapy on the basis of side effects.
Recent findings confirms that most of the treatments used for PTS are effective. However, because of the low quality of these trials their effectiveness should be viewed with skepticism. Given that this is a chronic low-pain disease, the effects of some treatments for PTS are difficult to judge. In particular, the benefits of physical exercise and the use of analgesics remain elusive.
A trial of low-dose aspirin and oral hydroxyzine showed a low absolute risk and safety on a high adverse event rate. Recent findings suggests that, in the presence of low bleeding risk and few adverse events, nonsteroidal anti-inflammatory drugs and NSAIDs are effective and safe therapies for thrombosis prophylaxis.