{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T21:29:50Z","timestamp":1782422990531,"version":"3.54.5"},"reference-count":89,"publisher":"Georg Thieme Verlag KG","issue":"08","funder":[{"name":"CanVECTOR","award":["I.M. was funded by a CanVECTOR fellowship."],"award-info":[{"award-number":["I.M. was funded by a CanVECTOR fellowship."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The postthrombotic syndrome (PTS) is chronic venous insufficiency secondary to a prior deep vein thrombosis (DVT). It is the most common complication of venous thromboembolism (VTE) and, while not fatal, it can lead to chronic, unremitting symptoms as well as societal and economic consequences. The cornerstone of PTS treatment lies in its prevention after DVT. Specific PTS preventative measures include the use of elastic compression stockings and pharmacomechanical catheter-directed thrombolysis. However, the efficacy of these treatments has been questioned by large randomized controlled trials (RCTs). So far, anticoagulation, primarily prescribed to prevent DVT extension and recurrence, appears to be the only unquestionably effective treatment for the prevention of PTS. In this literature review we present pathophysiological, biological, radiological, and clinical data supporting the efficacy of anticoagulants to prevent PTS and the possible differential efficacy among available classes of anticoagulants (vitamin K antagonists [VKAs], low molecular weight heparins [LMWHs] and direct oral anticoagulants [DOACs]). Data suggest that LMWHs and DOACs are superior to VKAs, but no head-to-head comparison is available between DOACs and LMWHs. Owing to their potentially greater anti-inflammatory properties, LMWHs could be superior to DOACs. This finding may be of interest particularly in patients with extensive DVT at high risk of moderate to severe PTS, but needs to be confirmed by a dedicated RCT.<\/jats:p>","DOI":"10.1055\/a-1711-1263","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:14:39Z","timestamp":1638404079000},"page":"1255-1264","source":"Crossref","is-referenced-by-count":21,"title":["Prevention of the Postthrombotic Syndrome with Anticoagulation: A Narrative Review"],"prefix":"10.1055","volume":"122","author":[{"given":"Ilia","family":"Makedonov","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Department of Medicine and Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jameel","family":"Abdulrehman","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8512-9043","authenticated-orcid":false,"given":"Sam","family":"Schulman","sequence":"additional","affiliation":[{"name":"Thrombosis and Atherosclerosis Research Institute, Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0227-1245","authenticated-orcid":false,"given":"Aurelien","family":"Delluc","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Division of Hematology, Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University and the Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Galanaud","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,2,15]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"923","DOI":"10.3390\/jcm9040923","article-title":"Prevention and management of the post-thrombotic syndrome","volume":"9","author":"I Makedonov","year":"2020","journal-title":"J Clin Med"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"567","DOI":"10.2146\/ajhp110241","article-title":"Quality of life and economic costs associated with postthrombotic syndrome","volume":"69","author":"S Kachroo","year":"2012","journal-title":"Am J Health Syst Pharm"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1111\/j.1538-7836.2011.04516.x","article-title":"Economic burden and cost determinants of deep vein thrombosis during 2 years following diagnosis: a prospective evaluation","volume":"9","author":"R Guanella","year":"2011","journal-title":"J Thromb Haemost"},{"issue":"03","key":"ref4","first-page":"417","article-title":"What is the effect of venous thromboembolism and related complications on patient reported health-related quality of life? 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