Post-operative Benefit of Compression Therapy after Endovenous Laser Ablation for Uncomplicated Varicose Veins: A Randomised Clinical Trial

Ye, K.; Wang, R.; Qin, Jining; Ye, Kaichuang; Yin, Meng; Liu, Xinyu; Jiang, Mier; Lu, Xinwu

doi:10.1016/j.ejvs.2016.09.005

Cited by 38 publications

(36 citation statements)

References 22 publications

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“…Analysis; however, was on 69 patients (40 patients were excluded for various reasons) and found that, at 1 week, the VAS was significantly better in those patients having compression for 7 days compared to those wearing stockings for only 48 hours (VAS score: 2.0 vs 3.7; P 0.001). Similarly, Elderman et al (2014) and Ye et al (2016) found less pain in those wearing compression stockings. 24,25 Ayo et al (2016) indicated a trend for less pain in those wearing compression stockings postablation, although this was only a secondary outcome and the sample size calculation did not look at the number needed to demonstrate a significant difference.…”

Section: Discussionmentioning

confidence: 84%

“…Similarly, Elderman et al (2014) and Ye et al (2016) found less pain in those wearing compression stockings. 24,25 Ayo et al (2016) indicated a trend for less pain in those wearing compression stockings postablation, although this was only a secondary outcome and the sample size calculation did not look at the number needed to demonstrate a significant difference. 26 For their part, Krasznai et al (2016) found no significant differences in leg volume or pain scores in their RCT of 101 patients receiving either 4 hours or 72 hours of compression stockings after RFA.…”

Section: Discussionmentioning

confidence: 84%

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Randomized Controlled Trial of Compression After Endovenous Thermal Ablation of Varicose Veins (COMETA Trial)

et al. 2019

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Background: The 21st century has witnessed a rise in the use of endovenous thermal ablation. Being highly clinically and cost-effective and improving the quality of life of patients, they are now considered to be the ''gold-standard'' treatment for varicose veins. Postintervention management, especially in terms of postoperative compression; however, remains unclear. As a result, a randomized study was undertaken to investigate the effects of wearing compression stockings after varicose vein treatment. Method: Patients with saphenous vein reflux undergoing treatment with endothermal ablation (with or without concurrent phlebectomies) were randomized to receive either 7 days of compression stockings or no stockings. The primary outcome measure for this study was the pain score over the first 10 postoperative days. The pain scores, clinical score, time to return to normal activities, and ecchymosis were assessed. Patients were followed-up at 2 weeks and 6 months post-ablation. Results: In total, 206 patients were randomized, 49% of them to the compression group. The mean age was 49.7 (AE16) years and approximately 51% of the population was male. The median pain score in the compression group using a visual analog scale was significantly lower on days 2-5, compared to the no compression group. Those having concurrent phlebectomies and compression stockings also had significantly better pain scores on days 1-3, day 5, and day 7. Improvement in the median venous clinical severity score was noted at 6-month follow-up, but this was not significant. No difference in the generic-or disease-specific quality of life was observed and the time to return to activities was similar. There were no differences in the degree of ecchymosis between the 2 groups and both groups had similar occlusion rates. Conclusions: These results indicate that wearing compression stockings after endothermal ablation is advantageous in the first few days after treatment and is especially beneficial for those having concurrent phlebectomies.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 84%

Randomized Controlled Trial of Compression After Endovenous Thermal Ablation of Varicose Veins (COMETA Trial)

et al. 2019

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“…Importantly, a further 29 articles were excluded as they included patients at moderate or high-risk of HAT. 15–43 After full-text exclusions took place, a narrative synthesis was performed on a single article. 44…”

Section: Resultsmentioning

confidence: 99%

Systematic review on the benefit of graduated compression stockings in the prevention of venous thromboembolism in low-risk surgical patients

et al. 2020

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Objectives The aim of this systematic review is to assess the performance of graduated compression stockings (GCS) in comparison to no venous thromboembolism (VTE) prophylaxis in the prevention of hospital-acquired thrombosis in low-risk surgical patients undergoing short-stay procedures. Methods Aligning with PRISMA guidelines, online databases MEDLINE and EMBASE, Cochrane Library® and trial registries were searched. Eligible articles reported the VTE rate in low-risk surgical patients either receiving GCS or no VTE prophylaxis. Results Narrative synthesis was performed on a single eligible article. The included study arm consisted of participants undergoing knee arthroscopy with the use of GCS alone reporting a total of 29 VTE events (4.4%), 16 of which were asymptomatic DVTs (2.4%). Conclusion There is a complete lack of evidence to support the use of GCS in the prevention of HAT for low-risk surgical patients. An adequately powered trial is required to provide level-IA evidence to support this practice.

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“…However, the study may have had insufficient power to test the hypothesis. Ye K et al 30 compared elastic bandage for 24 h followed by elastic compression stocking for at least two weeks (n ¼ 200) with elastic bandage alone (n ¼ 200), and reported a comparable pain score at 24 h and lower pain score at one week with compression therapy following EVLT. However, pain score data were collected from only approximately 40% of patients.…”

Section: Discussionmentioning

confidence: 99%

Editor's Choice – Role of Compression After Radiofrequency Ablation of Varicose Veins: A Randomised Controlled Trial☆

Onwudike

Abbas

Thompson

et al. 2020

European Journal of Vascular and Endovascular Surgery

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This study examined the effect of post-procedure leg compression in a full range of patients with superficial truncal incompetence treated exclusively with radiofrequency ablation (RFA). There was no significant difference in the target vein occlusion rate, quality of life, venous clinical severity score, patient satisfaction, and pain score with or without compression. This study provides further evidence that varicose vein patients undergoing RFA may not require post-procedure compression. Objective: Post-procedure limb compression, hitherto routine following open varicose vein surgery, has been extended to endovenous procedures. However, no robust evidence exists to support this practice. Most of the previous studies have focused on the ideal duration of compression. This study evaluates the clinical and patient reported outcomes with and without post-procedure leg compression following radiofrequency ablation (RFA). Methods: This single centre, prospective, non-inferiority randomised controlled trial recruited adult patients, into two groups (A: RFA with compression stocking for two weeks, B: RFA alone). The primary outcome was ultrasound determined target vein obliteration at 12 weeks. Secondary outcome measures included a Quality of Life (QoL) score [Aberdeen Varicose Vein Severity Score (AVSS) and Revised Venous Clinical Severity Score (RVCSS)], patient satisfaction, pain score, and complications. Results: In total, 100 consecutive patients were recruited (A: 51; B: 49) classified as clinical class C2eC6 of the Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification. At 12 weeks the occlusion rate of the target vein was similar in both groups at 98% (n ¼ 47) and 98% (n ¼ 45), respectively (p ¼ 1.0). There was no statistically significant difference in mean AVSS 6 vs. 5.0 (mean difference À1, 95% CI À2 e 3, p ¼ .57) and mean RVCSS 3 vs. 4 (mean difference 1, 95% CI À1 e 2, p ¼ .46) scores at 12 weeks. Comparable patient satisfaction scores were observed (p ¼ .72) and pain score 2.0 vs. 2.0 (p ¼ .92) were achieved in both groups. Two patients in each group developed deep vein thrombosis at two weeks follow up (p ¼ 1.0 for above the knee and p ¼ 1.0 for below the knee). Conclusion: The clinical and patient reported outcomes following RFA without compression are no worse than with compression. This trial supports the conclusion that the widely practised use of compression after RFA adds no clinical benefit for the patients. However, a much larger study, preferably a multicentre trial, may be required to confirm this conclusion.

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Post-operative Benefit of Compression Therapy after Endovenous Laser Ablation for Uncomplicated Varicose Veins: A Randomised Clinical Trial

Abstract: The use of an ECS does not prove to be of greater benefit in the quality of life and the mean time to return to work; ECS therapy does reduce the severity of pain and oedema during the first week after surgery in patients with uncomplicated varicose veins.

Cited by 38 publications

References 22 publications

Randomized Controlled Trial of Compression After Endovenous Thermal Ablation of Varicose Veins (COMETA Trial)

Randomized Controlled Trial of Compression After Endovenous Thermal Ablation of Varicose Veins (COMETA Trial)

Systematic review on the benefit of graduated compression stockings in the prevention of venous thromboembolism in low-risk surgical patients

Editor's Choice – Role of Compression After Radiofrequency Ablation of Varicose Veins: A Randomised Controlled Trial☆

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