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Post-Thrombotic Syndrome [PTS]:
The Villalta Score

Introduction

The Villalta score is specific for PTS. It can be used to both diagnose and categorise the severity of the condition. The Villalta score involves both the patient who grades the presence and severity (0–3 points) of five symptoms and the physician/nurse who grades six clinical signs (0–3 points) after examination of the lower limb.

The Villalta score is summarised below:

The Villalta Score:



Select Criteria:

Symptoms Scored by the Patient
Pain
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Cramps
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Heaviness
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Parasthesiae
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Pruritus
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Physician-Nurse
Assessment of Clinical Signs
Pre-tibial oedema
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Hyper-pigmentation
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Redness
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Venous Ectasia
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Pain on calf compression
Absent 0 Points
 Mild 1 Point
 Moderate 2 Points
 Severe 3 Points
Ulcers
If the cumulative score is <15 and ulcers are present then 15 is added to the final score
Present: severe PTS 15 Points
Absent 0 Points

Score

[Max Score Points]

Interpretation
Score PTS Risk Category
 < 5 Points No PTS
 ≥ 5 Points Any grade of PTS
 5-9 Points Mild PTS
 10-14 Points Moderate PTS
 ≥ 15 Points
or 
the presence of an ulcer		 Severe PTS


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Comments

NOTE: Whilst we have done our utmost to ensure the accuracy of the data in this section, users should access the original publications.

All information contained in this section of Practical-Haemostasis.com is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease.

The user of Practical-Haemostasis.com, assumes sole responsibility for any decisions made or actions taken based on the information contained herein.

1. The Villalta scoring system for PTS should be used in patients with a history of a lower limb DVT.

2. One of the problems with the Villalta scoring system is that the symptoms and signs that are assessed are not specific for PTS.

LINKS & References

1. Villalta S, Bagatella P, et al. Assessment of validity and reproducibility of a clinical scale for the post thrombotic syndrome. Haemostasis. 1994; 24: 158a.

2. Utne KK, Ghanima W, et al. Development and validation of a tool for patient reporting of symptoms and signs of the post-thrombotic syndrome. Thromb Haemost. 2016; 115: 361-7.

3. Kahn SR. Measurement properties of the Villalta scale to define and classify the severity of the post-thrombotic syndrome. J Thromb Haemost. 2009; 7: 884-8.

4. Wik HS, Ghanima W, et al. Scoring Systems for Postthrombotic Syndrome. Semin Thromb Hemost. 2017; 43: 500-4.

5. Soosainathan A, Moore HM, et al. Scoring systems for the post-thrombotic syndrome. Journal of Vascular Surgery. 2013; 57: 254-61.

6. Thaler J, Ay C, et al. Venous thromboembolism in cancer patients - risk scores and recent randomised controlled trials. Thromb Haemost. 2012; 108: 1042-8.

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Updated:         27-Sep-2022