Current approaches to the prevention and treatment of post-thrombotic syndrome

Venous thrombosis (VT) and its complications, such as postthrombotic syndrome (PTS), lead to a deterioration of the life quality and therefore represent an urgent medical problem. Despite the availability of a number of preventive and therapeutic methods, the incidence of PTS development after VT remains high. Objective. To perform the analysis of current approaches to the prevention and treatment of postthrombotic syndrome developing in presence of venous thrombosis. Materials and methods. An analysis of literature was carried out using international databases (PubMed, Scopus, Web of Science) during the study. Articles published since 2018 on VT pathophysiology, risk factors, preventive and therapeutic strategies in relation to PTS were selected. Results. A high efficacy of pharmacological and mechanical methods of VT and PTS prevention, such as anticoagulation and compression therapy, has been established. The use of pharmacomechanical thrombolysis did not reduce the risk of PTS development, but was accompanied by a high probability of bleeding occurrence. Invasive methods, including balloon angioplasty and stenting, have provided satisfactory results for the restoration of venous bloodstream. The effectiveness of reconstructive operations, such as bypass surgery and implantation of bioprosthetic valves has been shown, but there is a need for further studies with an increased sample size. Conclusion. The prevention and treatment of postthrombotic syndrome should be based on a comprehensive approach including a combination of pharmacological, mechanical and surgical methods. The results of this study emphasize the need for further improvement of methods and standardization of approaches to postthrombotic syndrome treatment in order to improve patients’ life quality.