Recent evidence suggests elastic compression stockings may not prevent post-thrombotic syndrome, whereas direct oral anticoagulants and novel medical therapies for CTEPH offer new therapeutic avenues.
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Questions routine compression stockings for PTS prevention; leaves open DOAC and CTEPH therapy potential pending trials.
Post-thrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (CTEPH) are late complications of venous thromboembolism. The purpose of this review is to present and discuss recently published studies that have improved our knowledge of PTS and CTEPH. The current understanding of the pathophysiology of PTS and CTEPH is discussed as well as the importance of chronic residual venous thrombosis, some polymorphisms of plasminogen activator inhibitor-1, and the current concept of misguided thrombus resolution. The surprising finding that elastic compression stockings may not be effective in preventing PTS and the novel medical treatment in CTEPH are discussed in detail. Novel direct oral anticoagulants show potential for prevention of PTS. No firm conclusions can be drawn on the efficacy of elastic stockings. Novel treatments of CTEPH for inoperable patients and those with persistent pulmonary hypertension after surgery have become available and further research on wider indication for their use is urgently needed.
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Pesavento et al. (2015) conducted a review in Post-thrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (CTEPH). Elastic compression stockings, direct oral anticoagulants, and novel medical treatments was evaluated.
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