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Diagnostic Criteria for Post Thrombotic Syndrome - Vein Treatment Center in Buffalo Niagara welcomes Canadian patients with venous disorders and post thrombotic syndrome
Monday, August 12, 2013



Diagnosis of post thrombotic syndrome (PTS) has two components, namely clinical assessment with the Villalta score as well as duplex ultrasound study to document venous valvular incompetence.  The Villalta score is a clinical measurement of post thrombotic syndrome that grades the severity of the syndrome from 0 (absent) to severe (3) of five patient related symptoms which include pain, cramps, heaviness, pruritus, and paresthesias and six clinical signs which include edema, redness, induration of the skin, hyperpigmentation, venous ectasia or telangiectasia and pain on calf compression.


A Score of greater than or equal to five on the Villalta score indicates the presence of post thrombotic syndrome.  Mild post thrombotic syndrome has a score of five to nine, moderate post thrombotic syndrome has a score of 10 to 14 and severe post thrombotic syndrome has a score of greater than 14 or the presence of a venous stasis ulcer.


An evaluation by duplex ultrasonography of both lower extremities is necessary. Venous reflux should be sought and documented if it exists in the deep veins - the common femoral vein, femoral vein, popliteal vein, and posterior tibial veins – as well as in the superficial veins (great saphenous and small saphenous).


The presence of post thrombotic syndrome after total knee arthroplasty in a recent study was 28.9% by clinical assessment with the Villalta score.  Patients who have had total knee arthroplasty or total knee replacement therefore should have duplex ultrasonography if they continue to have symptoms that suggest post thrombotic syndrome.


To obtain a free copy of Dr. Karamanoukian’s book about postthrombotic syndrome contact him directly through or call  716-839-3638.



Post Thrombotic Syndrome and Deep Vein Thrombosis



To be evaluated and treated for post thrombotic syndrome treatment center by Dr. Hratch Karamanoukian, MD FACS call 716-839-3638 or go to or and are partners with




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