Postthrombotic Syndrome: Therapy

General measures

  • Walk and lie down a lot, sit and stand a little
  • Cold showering of the legs should be done regularly
  • Heat such as sauna, sunbathing and thermal baths leads to vein dilation and should therefore be avoided

Measures in venous leg ulcers

  • Cleaning of the ulcer
  • Compression bandage

Operative therapy

  • Only if conservative therapy fails! The goal is the rehabilitation of insufficient veins.
  • Indications
    • Varicosis (varicose veins)
    • Obstructions (partial or complete occlusion of the lumen of a vessel), e.g., iliac vein obstruction
  • Procedure for varicose veins: see below the disease “varicose veins”.
  • Procedures for obstruction: endovascular recanalization (reopening of an occluded vessel) with stent angioplasty (widening or reopening of narrowed or occluded blood vessels with the use of stent (vascular bridge)) and open bypass surgery (vascular surgical bridging of a narrowed section of blood vessel by a bypass vessel, the bypass) of iliac obstructions; endovascular procedures achieve openness rates of 73-100%.

Medical devices

  • Compression stockings (gold standard), these come in the following different compression levels:
    • Light compression
    • Medium compression
    • Strong compression
    • Very powerful compression
  • Compression stockings must be fitted precisely and should always be put on in the morning before getting up, when the legs are not congested.
  • Contraindications for compression stockings:
    • Arterial circulatory disorders of the legs.
    • Decompensated heart failure (heart failure with water retention in the tissues (edema) or shortness of breath (dyspnea), which already occurs at rest)

    Notice. Medical compression stockings may be useless in the prophylaxis of post-thrombotic syndrome: they can prevent neither DVT recurrences (DVT = deep vein thrombosis) nor leg ulcers (Ulcus cruris).

Vaccinations

Tetanus vaccination protection should always be checked in cases of venous leg ulcers (chronic leg wounds are known entry sites for tetanus bacteria)

Nutritional Medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Light endurance training (cardio training).
  • The best prevention of complications is strengthening the leg muscles. This leads to the promotion of blood return in the venous system and the prevention (prevention) of inflammation and thrombosis at the venous valves.
  • Foot exercises help to avoid limiting the mobility of the ankle joint
  • Preparation of a fitness or training plan with appropriate sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Physical therapy (including physiotherapy)