Late-Breaking Data from EFFORT-2 Highlights the Life-Saving Benefits of Aerobic Exercise with Anticoagulation Therapies in Patients with Lower Extremity Deep Vein Thrombosis
BOSTON, MA, JUNE 13, 2026 – New research conducted at the VA Maryland Health Care System in collaboration with University of Maryland School of Medicine finds that 100% of deep vein thrombosis (DVT) patients who combined regular aerobic exercise with blood thinners remained free of post-thrombotic syndrome (PTS), an extreme, debilitating form of DVT. Researchers presented this data today as a late-breaking abstract at the Society for Vascular Surgery’s Vascular Annual Meeting, VAM26.
Every year, up to 900,000 Americans are diagnosed with DVT, a blood clot that forms in the deep veins of the leg. The current standard of care for sudden lower extremity deep vein thrombosis (LE-DVT) is anticoagulation (AC), or blood thinners. While AC helps reduce the risk of pulmonary embolism, when a clot breaks off and travels to the lungs, it does not allow the clot to dissolve fully on its own. When a clot is unable to fully dissolve, it can cause the vein to become swollen and painful, leading to PTS in 25-50% of LE-DVT patients. While AC is the most common treatment for resolving blood clots, aerobic exercise is a simple, underexplored approach that naturally increases blood flow to support clot breakdown.
Supported by a $1 million 5-year VA Merit Grant, EFFORT-2 is a randomized controlled trial that compares the effectiveness of standard AC versus AC combined with aerobic exercise in preventing PTS in LE-DVT patients after one year. Patients were randomly selected 1:1 to either group, and each cohort was well-matched for age, sex, body mass index, and clot states. On top of routine AC medication, the exercise group participated in 30 minutes of moderate treadmill walking three times a week for three months, to achieve at least 50% of predicted VO2 max. The primary outcome was the rate of occurrence of moderate or severe PTS (defined as a Villalta score of ≥10) at one year of follow-up.
The study enrolled 102 patients, the majority of whom were male (62%), and the cohort mean age was 53.8 ± 13.7 years. One-year Villalta scores were available for 48 patients on AC and 45 patients prescribed AC plus exercise (93 total). Results found that 12.5% of participants who took AC alone developed moderate or severe PTS (Villalta score ≥10), while 100% of the cohort that followed an exercise and AC regimen remained PTS-free (p=0.027). Patients who exercised showed milder symptoms on average than those on the standard AC treatment (Exercise group: 2.11 ± 2.06 standard deviation [SD] vs. AC group: 3.83 ± 4.37 SD).
“This study shows that early regular aerobic exercise is a safe, low-risk addition to standard anticoagulation therapies that reduces post-thrombotic syndrome severity after acute DVT,” said lead author Dr. Brajesh K. Lal, chief of Vascular Surgery at the VA Maryland Health Care System’s Baltimore VA Medical Center and professor of Surgery at the University of Maryland School of Medicine. “Since most DVT cases are diagnosed and managed by non-vascular surgeons, our findings are especially important for physicians and nurse practitioners who may have less familiarity with treating the condition. We can now see the value of exercise as not only a preventative strategy, but also a therapeutic one.”
Authors warrant further research on clot-busting blood chemicals and blood clot size following aerobic exercise intervention.
Session Details:
- “A Randomized Controlled Trial of Structured Exercise to Prevent Post-Thrombotic Syndrome After Acute Deep Vein Thrombosis (EFFORT-2)”
- Saturday, June 13th, from 7:00-9:30 am ET (Plenary 7)
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About the Society for Vascular Surgery
The Society for Vascular Surgery® (SVS) seeks to advance excellence and innovation in vascular health through education, advocacy, research, and public awareness. The organization was founded in 1946 and currently has a membership of approximately 6,500. SVS membership is recognized in the vascular community as a mark of professional achievement. For more information, visit Vascular.org.
About VAM26
The Society for Vascular Surgery’s Vascular Annual Meeting (VAM) will be held in Boston, MA, on June 10-13. Leading physicians, researchers, and health care professionals in vascular surgery gather for three full days of groundbreaking educational content showcasing the latest data, research, and innovations in vascular surgery and vascular health. For more information, visit vam.vascular.org.
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