The purpose of this study is to determine if complex lymphedema therapy is effective in
decreasing disease severity and improving quality of life in patients with post thrombotic
Post thrombotic syndrome (PTS) has a spectrum of disease manifestations ranging from minor
skin discoloration to severe skin changes and venous ulcerations. Pain is often a prominent
symptoms and PTS impairs patient quality of life. Prevention of PTS using compression
stockings has been emphasized. There is a paucity of validated, effective treatments for
PTS once the condition develops.
While the pathophysiology of PTS is incompletely understood, chronic venous hypertension and
insufficiency may increase the workload of the lymphatic system and result in
over-capacitance with secondary damage and eventual lymphatic insufficiency. In selected
patients with PTS, we have noted a symptomatic improvement in patients who receive
lymphedema therapy to the limb.
Complex lymphedema therapy (CLT) is a noninvasive treatment that includes four key
components: meticulous skin care, manual lymph drainage, compression therapy, exercises and
patient education for home management and continuation of the treatment. These techniques
are designed to enhance lymph flow through intact cutaneous lymphatics and reduce swelling
and restore function in the affected limb.
- Age >18 years.
- Diagnosis of post thrombotic syndrome.
- Median life expectancy of greater than 2 years.
- Previous history of lower extremity deep venous thrombosis.
- Acute venous thrombosis of the lower extremity within the last 180 days.
- Unable to participate in lymphedema therapy due to monetary, physical or
- Uncontrolled illness including, but not limited to, ongoing or active infection,
symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia,
or psychiatric illness/social situations that would limit compliance with study
- Pregnant women and women in their first post-partum month.