Evaluating the Role of Compression Stockings in Preventing Post thrombotic Syndrome: A Review of the Literature

Abstract

Background. Postthrombotic syndrome (PTS) is a burdensome and costly complication of deep vein thrombosis (DVT). Up to 50% of patients with DVT will develop the disease within two years following the diagnosis of acute DVT. Various risk factors for developing PTS have been identified and different modalities have been used to prevent its development. Compression stockings have been studied for the prevention of PTS in patients diagnosed with proximal DVT. Methods. MEDLINE and EMBASE databases were searched to identify relevant original articles. Results. Several trials including two metaanalyses have examined the role of compression stockings for the prevention of PTS. Although most trials showed significant reduction in the development of PTS with the use of compression stockings, limitations in study design prevent the generalizability of the data. Two studies supported an individualized tailored duration especially in patients at low risk for developing the syndrome. A randomized double-blind placebo-controlled trial involving 800 patients is currently ongoing and may confirm the results of older studies. Conclusions. Clinical trials support the use of compression stockings in patients diagnosed with proximal DVT for the prevention of PTS.

Elastic compression stockings fail to prevent post-thrombotic syndrome after a first deep vein thrombosis

“…Venous hypertension, resulting from valvular reflux and residual thrombus, is implicated in the pathophysiology of PTS 2. Elastic compression stockings reduce venous hypertension and have been evaluated for the prevention of PTS; however, limitations in trial design affect the generalisability of published results 3. The study by Kahn and colleagues aims to evaluate the role of compression stockings in the prevention of PTS while addressing the methodological limitations of previously published trials.…”

“…These include modifying patient-specific risk factors, enhancing the time within therapeutic range and optimising duration of therapy when using anticoagulants, preventing recurrent ipsilateral DVT, and surgically intervening on venous valves 3. Although compression stockings should not be used to prevent PTS after an acute DVT, their role in treating symptoms of established PTS remains understudied and warrants further investigation.…”

Utilizing tension reduction in a dielectric elastomer actuator to produce compression for physiological application

“…The use of graduated compression stockings in reducing venous calliper and augmenting venous return has been investigated extensively in the literature with significant dissent on its efficacy (Byrne, 2001; Kanaan et al, 2012; MacRae et al, 2011; Partsch and Partsch, 2005). This inconsistency in results can be attributed in part to the passive nature of the compression; it is shown by Book et al (2016) that the load applied by the compression sock can differ largely across various applications.…”

On the improvement of the dynamic performance of dielectric elastomer actuators for active compression

“…In order to combat venous pooling, passive external compression to the lower limbs is commonly applied using graduated compression stockings (GCS). Several studies in the literature present conflicting results of the effectiveness of GCS in reducing venous calliper and augmenting venous return (Kanaan et al, 2012; Lord and Hamilton, 2004; MacRae et al, 2011; Vercruyssen et al, 2014). In Book et al (2016), it is shown that there is a large amount of variability in the applied pressure based on the leg geometry and each individual application; furthermore, it is shown that the pressure gradient from the ankle to the knee commonly did not meet the manufacturer specs (10 mmHg) even when the proper sizing protocol was followed.…”