In symptomatic post-thrombotic syndrome, (PTS), treatment is often a challenging, evolving and many times a lifelong undertaking. Elastic compression stockings are still considered to be the cornerstone of conservative therapy for PTS. Leg elevation, and herbal remedies such as aescin, (horse chestnut tree extract), rutosides, and pentoxifylline, may also be helpful. Often, a person with PTS has multiple venous insufficiencies causing the persistant pain, swelling and skin changes. A complete non-invasive ultrasound evaluation can be performed to make a detailed "vein map". This can determine if and which veins are obstructed and/or incompetent. A trained phlebologist or vascular specialist can then determine if any minimally invasive or invasive procedures may be helpful in your particular case.
Post Thrombotic Syndrome can occur years after a DVT, even despite diligent compression stocking use. This is a challenging question as treatment for problematic leg veins causing your leg symptoms, after having a DVT and PE, depends on many factors, so a complete evaluation would be recommended first. In short, yes, there are treatments that can be done to close some of the veins causing your leg symptoms if a few conditions are met, if you are healthy and medically suitable for treatment, and if your pulmonary embolism and leg DVT have completely resolved. An ultrasound can check your leg veins to see if any residual clot remains in your veins. If all seems clear and treatment is recommended, then treatment can proceed and you can remain on your Coumadin, you don't have to go off Coumadin like you do for most other procedures.
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