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Post-thrombotic syndrome
Post-thrombotic syndrome is a chronic complication that can appear after a deep vein thrombosis. Even if the clot has been treated, the veins and their valves can remain damaged and blood does not return well to the heart. It is estimated to affect between one fifth and one half of the people who have had a thrombosis in the leg. It causes pain, heaviness, swelling and, in severe cases, skin changes and ulcers. There is no single cure, but with treatment and care it can be controlled.
In summary
- It appears months or years after a deep vein thrombosis in the leg.
- Symptoms: heaviness, pain, swelling, itching, skin color changes and, sometimes, ulcers.
- It is diagnosed from the history of the thrombosis, the examination and Doppler ultrasound.
- It is treated with compression, exercise, skin care and, in selected cases, procedures.
What is post-thrombotic syndrome?
It is the set of chronic symptoms that remain in a leg after a deep venous thrombosis. The clot can damage or destroy the vein valves, or leave them partly blocked. As a result, blood pools in the leg and the pressure inside the veins rises, just as it does in chronic venous insufficiency.
Symptoms
- Heaviness, tiredness or pain in the leg, which gets worse when standing or at the end of the day.
- Swelling that improves when the leg is raised.
- Cramps, itching or tingling.
- New varicose veins or more visible veins.
- Skin that is darker, hardened or eczema-like, especially near the ankle.
- In severe cases, wounds that are slow to heal: venous ulcers.
The intensity varies a lot: some people have mild discomfort and others have symptoms that limit their daily life.
Why it appears and who is at higher risk
- A thrombosis involving the proximal veins, such as the femoral or iliac vein.
- A new thrombosis in the same leg.
- Obesity.
- Significant symptoms during or shortly after the thrombosis.
- Insufficient anticoagulation or stopping it too early.
- Previous venous insufficiency or varicose veins.
Not everyone with a thrombosis develops the syndrome. Following the anticoagulant treatment properly reduces the risk of new thromboses.
How it is diagnosed
There is no single test. The doctor combines the history of the thrombosis, the symptoms and the examination of the leg, and often uses scales to measure its severity. A venous Doppler ultrasound shows the state of the veins and their valves, detects obstructions, reflux and old clots, and helps decide the treatment.
The symptoms can be mistaken for those of a new thrombosis. That is why, if the leg suddenly swells or hurts more, you should seek care soon.
Treatment
The goal is to relieve symptoms, prevent it from getting worse and prevent ulcers. It is chosen according to the severity of each case.
Compression
Compression stockings, properly measured and prescribed by the doctor, help reduce swelling and heaviness and protect the skin.
Exercise and movement
Walking daily and doing ankle and calf exercises helps blood return. It is best to avoid standing or sitting still for long periods.
Raising the legs
Raising the legs several times a day relieves swelling.
Skin care
Moisturize the skin, treat eczema and protect the leg from knocks and wounds.
Medication and procedures
In some cases the doctor prescribes medication for the symptoms, or treatment of the varicose veins or venous obstructions, depending on the ultrasound findings. If there is an ulcer, the wound is treated and so is its venous cause.
Do not stop or change your anticoagulants on your own.
Care at home
- Use compression every day, as your doctor prescribed.
- Walk daily and do ankle exercises.
- Raise your legs several times a day.
- Keep a healthy weight.
- Check the skin on your legs and seek care if you see wounds, redness or changes.
- Attend your check-ups.
When to seek urgent care
- Sudden swelling, pain, warmth and redness in one leg: it may be a new thrombosis.
- Difficulty breathing, chest pain or coughing up blood: it may be a pulmonary embolism. Go to the emergency department immediately.
- A leg wound with fever, bad odor, pus or increasing pain.
- A cold, pale or purple leg.
Frequently asked questions
Does post-thrombotic syndrome always appear after a thrombosis?
No. It affects some of the people who have had a deep vein thrombosis, between one fifth and one half according to studies. Following the treatment properly helps reduce the risk.
When does it appear?
It can appear in the first months or several years after the thrombosis.
Can it be cured?
There is no single cure, but the symptoms can be controlled well with compression, exercise, skin care and, when needed, procedures.
Can I exercise?
Yes. Walking and moving your ankles helps circulation. The doctor will tell you which exercise is right for your case.
Is it the same as a new thrombosis?
No, but the symptoms can look alike. If the leg suddenly swells or hurts more than usual, seek care soon to rule it out.
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Book via WhatsAppThe information on this page is general and for guidance only. It does not replace a medical consultation. If you have a warning sign, go to the emergency department. The pages are written for patients in Colombia; consultations are in Spanish.
Last updated: October 16, 2026