The Role of Leg Compression in the Treatment of Deep Vein Thrombosis

Partsch, Hugo

doi:10.1177/0268355514528128

Cited by 14 publications

(11 citation statements)

References 17 publications

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“…2,7) Venous sheath placement itself might promote thrombogenesis by injuring the vessel wall, reducing the lumen and activating the coagulation cascade, 8) which of action is the increase of shear stress in microcirculation of the vein wall releasing anti-inflammatory and anti-coagulatory mediators. 10) Although compression therapies are costly, cumbersome to use, and can cause skin injury, they should be recommended as prophylaxis especially in patients with high risk of VTE. Generally, immediate contrast-enhanced CT scan is employed as the imaging modality of first choice to assess the severity of pulmonary thromboembolism.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Thromboembolism Caused by Prolonged Compression at the Femoral Access Site and a Venous Aneurysm of the Ipsilateral Popliteal Vein

Arakawa

Himeno

Kirigaya

et al. 2016

Annals of Vascular Diseases

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A 51-year-old female with dilated cardiomyopathy underwent a cardiac catheterization via right common femoral vein and artery. Prolonged compression with a bandage and extension of supine bed rest were needed. Immediately after standing up, she lost consciousness and developed electromechanical dissociation. The echocardiogram revealed a huge thrombus filling the main pulmonary trunk and massive enlargement of right ventricle, which suggested acute pulmonary thromboembolism (PTE). Images of computed tomography taken 2 months later detected a huge venous aneurysm of the right popliteal vein. Prolonged compression at the groin area might enhance blood stasis of the ipsilateral popliteal venous aneurysm, followed by life-threatening PTE.

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Section: Discussionmentioning

confidence: 99%

Pulmonary Thromboembolism Caused by Prolonged Compression at the Femoral Access Site and a Venous Aneurysm of the Ipsilateral Popliteal Vein

Arakawa

Himeno

Kirigaya

et al. 2016

Annals of Vascular Diseases

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“…Es zeigte sich eine positive Korrelation zwischen der Ejektionsfraktion und den Druckspitzen an der Wade, nicht aber in der Knöchelregion [13]. [22,23]. Für die Kompressionstherapie wird eine Dauer von 2 Jahren empfohlen.…”

Section: Kompressionstherapie Als Prophylaxe Beim Postoperativen Bypaunclassified

“…Für die Kompressionstherapie wird eine Dauer von 2 Jahren empfohlen. Wann immer möglich, sollten diese Patienten mobil bleiben und zu regelmäßigem Gehen in der Kompression angehalten werden [22]. Die Bewegung in der Kompression trägt dazu bei, den Venendurchmesser zu reduzieren, den venösen Abstrom zu erhöhen und die Scherkraftinduzierte Plättchenaktivierung und Entzündungsaktivität an der Venenwand zu reduzieren [22,24].…”

Section: Kompressionstherapie Als Prophylaxe Beim Postoperativen Bypaunclassified

“…Wann immer möglich, sollten diese Patienten mobil bleiben und zu regelmäßigem Gehen in der Kompression angehalten werden [22]. Die Bewegung in der Kompression trägt dazu bei, den Venendurchmesser zu reduzieren, den venösen Abstrom zu erhöhen und die Scherkraftinduzierte Plättchenaktivierung und Entzündungsaktivität an der Venenwand zu reduzieren [22,24]. Letztlich bleibt aber die Notwendigkeit für weitere Studien in diesem Indikationsgebiet mit der Frage nach einem optimalen Beginn und einer sinnvollen Dauer der Kompressionstherapie nach tiefer Beinvenenthrombose.…”

Section: Kompressionstherapie Als Prophylaxe Beim Postoperativen Bypaunclassified

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Aktuelle Aspekte der Kompressionstherapie in der Phlebologie

Reich‐Schupke

2014

Akt Dermatol

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Zusammenfassung Die Kompressionstherapie mit verschiedenen medizinischen Verb?nden und Strumpfsystemen gilt als Basisma?nahme der phlebologischen und lymphologischen Therapie. Sie kann allein oder in Kombination mit anderen interventionellen oder operativen Ma?nahmen angewendet werden. Ziel des aktuellen Beitrags ist es, auf drei derzeit in Diskussion befindliche, aktuelle Aspekte der Kompressionstherapie einzugehen. Dazu z?hlen: Kompressionstherapie bei peripherer arterieller Verschlusskrankheit, Vorteile der sogenannten progressiven Kompressionstherapie und Kompressionstherapie als Prophylaxe des postthrombotischen Syndroms.

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“…Regarding proper management, research data indicate that immediate compression and early walking also reduces the incidence of PTS [16]. One presumed mechanism of action of this adjunct treatment modality is the increase of shear stress in the microcirculation of the vein wall releasing anti-inflammatory and anti-coagulatory mediators [17]. Daily use of elastic compression stockings for 2 years after proximal DVT appears to reduce the risk as well [14]; however, there is uncertainty about optimal duration of use and compression strength of elastic stockings and the magnitude of their effect.…”

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confidence: 99%

Mobilisation after Lower Limb Deep Vein Thrombosis and Post-Thrombotic Syndrome

Galyfos¹

2015

J Nov Physiother

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EditorialDeep vein thrombosis (DVT) is one of the commonest cardiovascular diseases, ranking third behind coronary artery disease and stroke [1]. Furthermore, it is one of the major causes for inhospital morbidity and mortality, leading to severe complications such as pulmonary embolism (PE), post-thrombotic syndrome (PTS) and even death [2]. Local damage to venous intima, venous stasis and hypercoagulability are major predisposing factors, and it is thought that two of these factors must be present for a DVT to develop [3].Physiotherapists frequently handle in-patients diagnosed with a DVT, and management of such patients has been controversial. For decades, conservative management of DVTs using strict immobilization was based on the theoretical assumption that early ambulation and active range of motion would cause the thrombus to dislodge proximally, migrating to the pulmonary circulation and causing a PE, possibly leading even to death [4]. However, this assumption has never been tested empirically. Moreover, such a conservative treatment approach of bed rest can lead to secondary complications and can thus be detrimental for patients [4].Concerning proper management, immediate initiation of anticoagulation, and especially low molecular weight heparins (LMWH), has been proved to be the most important first-line treatment, and therefore, is recommended for acute DVT by the latest Guidelines (Level 2B) [5]. Anticoagulants also decrease the risk for subsequent PE and the incidence of thrombi propagation [6]. However, the same Guidelines underline also the importance of early ambulation over initial bed rest (Grade 2C), as well as the preference of treatment at home instead of in-hospital treatment (Grade 1B) [5]. Additionally, many systematic reviews conclude that there is no evidence proving that ambulation by anticoagulated DVT patients in the home setting increases the risk of PE development [4,7]. Aissaoui et al. showed in their recent meta-analysis that early ambulation in patients with DVT with or without PE was not associated with increased risk for DVT progression, new PE or even death [8]. Hence, experimental data also show that even exercise does not increase the risk for new PE, regardless of thrombus status [9]. Therefore, clinicians should be confident in prescribing ambulation in this population.Fear of PE is the main rationale for bed rest, while pain and swelling are expected to resolve faster during leg elevation. However, the rate of resolution of pain and swelling is significantly faster when the patient ambulates with compression [10]. Immediate multilayer compression bandaging in the acute phase of DVT seems to be effective in reducing edema and complaints in the first week, although it has no effect on thrombus regression or valve incompetence within the following year [11]. Regarding the initiation time of ambulation after setting the diagnosis, there are controversial results in literature. Kiser et al. underline that the patient should stay immobilized for at least 48 to 72 hours whi...

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The Role of Leg Compression in the Treatment of Deep Vein Thrombosis

Cited by 14 publications

References 17 publications

Pulmonary Thromboembolism Caused by Prolonged Compression at the Femoral Access Site and a Venous Aneurysm of the Ipsilateral Popliteal Vein

Pulmonary Thromboembolism Caused by Prolonged Compression at the Femoral Access Site and a Venous Aneurysm of the Ipsilateral Popliteal Vein

Aktuelle Aspekte der Kompressionstherapie in der Phlebologie

Mobilisation after Lower Limb Deep Vein Thrombosis and Post-Thrombotic Syndrome

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