Post-thrombotic syndrome: A potential cause of venous ulcer

Venous thromboembolism (VTE) consists of deep vein thrombosis (DVT) and pulmonary embolism (PE) and is a major cause of disease burden in Australia. A prospective study conducted in Perth, Western Australia, estimated the age-adjusted annual incidence of VTE to be 0.57 (95 CI, 0.47-0.67) per 1000 residents. There were over 14,700 cases of VTE in Australia in 2008, contributing to an estimated financial cost of 1.72 billion for that year. Post-thrombotic syndrome (PTS) is a frequently overlooked chronic complication of DVT, specifically proximal DVT (occurring at or above the popliteal vein). It is a clinical syndrome encompassing the presence of chronic pain, swelling, skin discolouration and, in severe cases, venous ulceration. It affects approximately one-third of patients following DVT, and about 5 to 10 of patients progress to severe PTS. It is the cause of significant morbidity and health care utilisation.