Long-term outcomes after deep vein thrombosis: Postphlebitic syndrome and quality of life

In this review, we critically assess the literature on the incidence of pos tphlebitic syndrome, risk factors for its occurrence, available therapeutic options, and its effects on quality of life. As well, we describe availabl e tools to measure postphlebitic syndrome. Recent prospective studies indic ate that postphlebitic syndrome, a chronic, potentially disabling condition characterized by leg swelling, pain, venous ectasia, and skin induration, is established by 1 year after deep vein thrombosis (DVT) in 17% to 50% of patients. The only prospectively identified risk factor for its occurrence is recurrent ipsilateral DVT. In the sole randomized study available, daily use of elastic compression stockings after proximal DVT reduced the incide nce of postphlebitic syndrome by 50%. Treatment options for established pos tphlebitic syndrome are limited, but include compression stockings and inte rmittent compressive therapy with an extremity pump for severe cases. To da te, quality of life after DVT has received little attention in the literatu re. The recent development of the VEINES-QOL questionnaire, a validated ven ous-disease-specific measure of quality of life, should encourage researche rs to include quality of life as a routine outcome measure after DVT. There is no criterion standard for the diagnosis of postphlebitic syndrome, but a validated clinical scoring system does exist. More research on postphlebi tic syndrome is needed to enable us to provide DVT patients with comprehens ive, evidence-based information regarding their long-term prognosis, to hel p quantify the prevalence and health care burden of postphlebitic syndrome, and by identifying predictors of poor outcome, to develop new preventive s trategies in patients at risk of developing this condition.