Hamostaseologie 2020; 40(03): 280-291
DOI: 10.1055/a-1171-0486
Review Article
Georg Thieme Verlag KG Stuttgart · New York

How to Differentiate Recurrent Deep Vein Thrombosis from Postthrombotic Syndrome

Gargi Gautam*
1  Department of Clinical Sciences, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden
2  Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland
Frederikus A. Klok
3  Department of Medicine – Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
› Author Affiliations
Further Information

Publication History

30 January 2020

05 May 2020

Publication Date:
29 July 2020 (online)


Venous thromboembolism (VTE) is associated with significant morbidity and mortality. Accuracy of diagnosis is thus of vital importance. Failure to diagnose VTE increases the risk of progression and complications. Conversely, anticoagulation as a result of an incorrect diagnosis exposes patients to the associated hazards of bleeding. The diagnostic management of recurrent deep vein thrombosis (DVT) and postthrombotic syndrome (PTS) is especially challenging due to the lack of well-established diagnostic standards. Particularly, the differentiation between the two is notoriously difficult as symptoms, clinical signs, and diagnostic test findings largely overlap. This review highlights the current diagnostic and management strategies for recurrent DVT and PTS with a focus on clinical findings and imaging modalities. We also discuss current open questions for clinicians in the field, anticipating future directions and predictions for the year 2050.

* Contributed equally.