Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Stockings, Compression”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2006

Efficacy of pneumatic compression stocking prophylaxis in the prevention of deep venous thrombosis and pulmonary embolism following 139 lumbar laminectomies with instrumented fusions.

OBJECTIVE: Low-dose heparin (LDH) regimens reduce the frequency of deep venous thrombosis (DVT) and pulmonary embolism (PE) in spinal surgery but pose a risk of postoperative hemorrhage threatening neurologic function. Pneumatic compression stocking (CS) could provide an alternative means of mechanical prophylaxis alone against DVT and PE and would possibly avoid its hemorrhagic complications. METHODS: The efficacy of CS alone in preventing DVT and PE was evaluated in 139 patients undergoing multilevel lumbar laminectomies (average 3.8 levels) with instrumented fusions (average 1.4 levels). All patients received CS stocking prophylaxis intraoperatively and throughout the average 5-day postoperative course including following ambulation. Doppler screening for DVT was routinely performed 2 days postoperatively. Subsequent Doppler studies or computed tomography angiograms were selectively performed in symptomatic patients with potential DVT/PE. RESULTS: Four (2.8%) patients developed DVT 2-6 days postoperatively and required inferior vena cava (IVC) filters. One of the four had a positive routine screening Doppler study performed the second postoperative day. Two developed DVT the fourth postoperative day. The fourth patient developed DVT 6 days postoperatively but 3 weeks later embolized around the IVC filter. This patient, the only one to develop a PE, tested positive for Factor V Leiden mutation (hypercoagulable syndrome) and remains on long-term warfarin. CONCLUSIONS: Pneumatic compression stocking prophylaxis effectively reduced the incidence of DVT (2.8%) and PE (0.7%) in 139 patients undergoing multilevel lumbar laminectomies with instrumented fusions. These rates compared favorably with those reported in spinal series employing LDH prophylaxis.

Adult↗
PubMed1996

Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency.

BACKGROUND: Diseases of the venous system are widespread disorders sometimes associated with modern civilisation and are among the major concerns of social and occupational medicine. This study was carried out to compare the efficacy (oedema reduction) and safety of compression stockings class II and dried horse chestnut seed extract (HCSE, 50 mg aescin, twice daily). METHODS: Equivalence of both therapies was examined in a novel hierarchical statistical design in 240 patients with chronic venous insufficiency. Patients were treated over a period of 12 weeks in a randomised, partially blinded, placebo-controlled, parallel study design. FINDINGS: Lower leg volume of the more severely affected limb decreased on average by 43.8 mL (n = 95) with HCSE and 46.7 mL (n = 99) with compression therapy, while it increased by 9.8 mL with placebo (n = 46) after 12 weeks therapy for the intention-to-treat group (95% CI: HCSE: 21.1-66.4; compression: 30.4-63.0; placebo: 40.0-20.4). Significant oedema reductions were achieved by HCSE (p = 0.005) and compression (p = 0.002) compared to placebo, and the two therapies were shown to be equivalent (p = 0.001); in this design, however, compression could not be proven as standard with regard to oedema reduction in the statistical test procedure. Both HCSE and compression therapy were well tolerated and no serious treatment-related events were reported. INTERPRETATION: These results indicate that compression stocking therapy and HCSE therapy are alternative therapies for the effective treatment of patients with oedema resulting from chronic venous insufficiency.

Bandages↗
PubMed1997

Compression stockings and rubber floor mats: do they benefit workers with chronic venous insufficiency and a standing profession?

Chronic venous insufficiency (CVI) is a burden to many workers, especially to those with a standing profession. Preventive measures are seldom taken. A quasirandomized parallel group trial was performed in 114 male workers with CVI and a standing profession. For 3 months, class II compression stockings or rubber floor mats were used vs controls. Outcome measures were diurnal volume changes (leg swelling) and complaints of the lower legs. With the stockings, a significant decrease in complaints was found, as well as a significant decrease in leg swelling. Rubber mats were often not suitable for hygienic and safety reasons. The decrease in complaints in the group using rubber mats was less pronounced, and leg swelling did not differ from that of the control group. Compression stockings appeared to be superior to rubber mats with regard to applicability, diminishing subjective complaints, and decrease of diurnal leg swelling.

Analysis of Variance↗
PubMed1997

Low molecular weight heparin associated with spinal anaesthesia and gradual compression stockings in total hip replacement surgery. Arar Study Group.

The benefit/risk ratio of administering heparin during spinal anaesthesia in patients undergoing total hip replacement (THR) has not been studied widely. We conducted a prospective, randomized, double-blind study to compare low molecular weight heparin (LMWH) for 10 days and placebo in patients undergoing THR performed under spinal anaesthesia associated with gradual compression stockings. Efficacy was assessed by systematic bilateral ascending venography on day 10 +/- 2 in a sequential analysis. Among the 170 patients enrolled, data were available in 153 patients. In the LMWH group (n = 78) the total incidence of deep vein thrombosis (DVT) was 14.1% compared with 37.3% in the placebo group (n = 75) (P = 0.0016). No gross neurological sequelae were observed during the study. This study showed that the addition of LMWH in patients undergoing THR under spinal anaesthesia and wearing gradual compression stockings significantly decreased the incidence of venogram-proved DVT.

Adult↗
PubMed1985

Heparin with and without graded compression stockings in the prevention of thromboembolic complications of major abdominal surgery: a randomized trial.

One hundred and seventy-six patients scheduled for elective major abdominal surgery were randomized to two prophylactic regimens to prevent postoperative thromboembolism. All patients were screened with the 125I-labelled fibrinogen uptake test, and thromboembolism was verified by ascending phlebography and/or perfusion/ventilation lung scintigraphy. In the group of patients receiving low-dose heparin treatment (5000 units twice daily subcutaneously) 12 per cent developed thromboembolic complications. In the other group, where low-dose heparin treatment was supplemented with graded compression stockings only 2 per cent developed thromboembolism. It is concluded that the combination of low-dose heparin and the use of graded compression stockings is superior to heparin alone in preventing thromboembolism following major abdominal surgery.

Abdomen↗
PubMed2005

Intramuscular pressure and surface EMG in voluntary ankle dorsal flexion: Influence of elastic compressive stockings.

Intramuscular pressure (IMP) is of major importance in blood flow and is often taken as a good estimate of muscular tension. However, its measurement remains invasive. The aims of the present work were: (1) to re-examine the possibility of evaluating IMP and muscular tension changes by means of surface electromyographic recordings, and (2) to clarify the influence of elastic compressive stockings (ECS). Surface EMG of muscles tibialis anterior (TA), soleus, gastrocnemius, and IMP from the anterior tibial compartment (ATC), deep posterior compartment (DPC), superficial posterior compartment (SPC) of the right leg, were simultaneously recorded in nine healthy subjects. Subjects performed series of voluntary concentric TA contractions (right ankle dorsal flexions) and TA isometric contractions, with or without elastic ECS, in a decubitus posture. Rest IMP mean values, measured over 60 s, ranged between 12.3 and 26.6 mmHg, i.e. in the range or slightly higher than those reported in the literature. When ECS were applied, mean IMP increase was 6.4 mmHg in ATC, 8.7 mmHg in DPC and 21.0 mmHg in SPC, while the corresponding EMG amplitude decreased. In ankle dorsal flexion movements, instantaneous values of TA-EMG amplitudes were linearly correlated to ATC-IMP instantaneous values, over the whole of the EMG rising part of every movement. When ECS were applied, the relationships between TA-EMG amplitude and ATC-IMP amplitude remained linear but where shifted towards higher IMP, in agreement with the increase in rest IMP. Because of antagonist co-contractions, IMP from DPC and SPC were also linearly correlated with ATC-IMP but with low coefficients of proportionality. As in TA concentric contractions, TA-EMG amplitudes were linearly correlated to ATC-IMP instantaneous values in isometric contractions, but the slopes of the latter were always greater. This result is explained by the relationship between muscle tension and shortening velocity. Al the results showed that: (1) instantaneous changes in surface EMG amplitude may provide a good estimate of IMP changes during the rising part of isometric, but also of concentric voluntary contractions; (2) elastic compressive stockings do not impair subjects relaxation capacity but actually increase the ratio IMP/muscle activation. As a consequence, ECS may actually increase the venous return during voluntary contractions.

Adaptation, Physiological↗
PubMed1991

Deep vein thrombosis: effect of graduated compression stockings on distension of the deep veins of the calf.

The mechanisms by which graduated compression stockings prevent deep vein thrombosis are not completely understood. Recent work has suggested that venous distension plays a role in initiating the process. Our previous work has shown that the deep veins of the lower limb distend in patients undergoing surgical procedures. We have investigated 40 patients receiving surgical treatment on the abdomen or neck. A medial gastrocnemius vein was studied using ultrasound imaging during the operations. In half the patients a graduated compression anti-embolism stocking was applied to the limb under study at the start of the operation, immediately after initial measurements of vein diameter. The median vein diameter in both groups was the same at the start of the operative procedures (control, 2.6 mm, interquartile range 2.1-3.3 mm; stocking, 2.6 mm, interquartile range 2.1-3.7 mm). After application of a stocking the median diameter in this group fell to 1.6 mm (interquartile range 1.3-2.8 mm) and then decreased slightly at the end of the operation. In the control group the vein diameter increased to 2.9 mm (interquartile range 2.3-4.0 mm) during the operative procedure.

Abdomen↗
PubMed1996

Low molecular weight heparin and compression stockings in the prevention of venous thromboembolism in neurosurgery.

Perioperative anticoagulant prophylaxis for postoperative venous thromboembolism (VTE) in neurosurgical patients has not gained wide acceptance due to the fear of intracranial bleeding. Physical methods give a worthwhile reduction of postoperative VTE but there still remains a substantial residual incidence. In other clinical indications, low molecular weight heparins have proven to be effective for prophylaxis of VTE when administered postoperatively, with the advantage of no bleeding enhancement during surgery. Therefore, we performed a multicentre, randomized, double-blind trial in neurosurgical patients to investigate the efficacy and safety of adding a low molecular weight heparin (LMWH), nadroparin, initiated postoperatively, to graduated compression stockings in the prevention of VTE. Deep-vein thrombosis was detected by mandatory venography. Bleeding was determined according to pre-defined objective criteria for major and minor episodes. An adequate bilateral venogram was obtained in 166 of 241 LMWH patients (68.9%) and 179 of 244 control patients (73.4%). A total of 31 of 166 LMWH patients (18.7%) and 47 of 179 controls patients (26.3) had VTE up to Day 10 postoperatively (p = 0.047). The relative risk reduction (RRR) was 28.9%. The rates for proximal deep-vein thrombosis/pulmonary embolism were 6.9% and 11.5% for the two groups, respectively (RRR: 40.2%; p = 0.065). Secondary analyses involved all VTE up to day 56 post-surgery which was detected in 33 patients of 241 in the LMWH group (13.7%) and 51 of 244 control patients (20.9%; RRR 34.5%; p = 0.018). The corresponding percentages for proximal deep-vein thrombosis/pulmonary embolism were 5.8% and 10.2% for the two groups, respectively, giving a RRR of 43.3%; p = 0.36. Major bleeding complications, during the treatment period, occurred in six low molecular weight heparin treated patients (2.5%) and in two control patients (0.8%); p = 0.87. A higher mortality was observed in the low molecular weight heparin group over the 56-day follow-up period (22 versus 10; p = 0.026). However, none of these deaths was judged by a blinded adjudication committee to be related to the study drug. In conclusion, this study demonstrates that the low molecular weight heparin, nadroparin, added to graduated compression stockings results in a clinically significant decrease in VTE without inducing any significant increase of major bleeding.

Anticoagulants↗
PubMed1996

The efficacy of pneumatic compression stockings in the prevention of pulmonary embolism after cardiac surgery.

INTRODUCTION: Pneumatic compression stocking (PCS) devices have been introduced to decrease the incidence of postoperative deep venous thrombosis (DVT). However, their role in the prophylaxis against pulmonary embolism (PE) remains unclear. This study was undertaken to compare the prophylactic effectiveness of subcutaneous heparin (SCH) alone vs the combined use of PCS and SCH in the prevention of PE following cardiac surgery. METHODS: We studied 2,551 consecutive patients who underwent cardiac surgery over a 10-year period. They were randomly allocated to two groups. Group A included 1,196 patients who were treated with 5,000 U of SCH every 12 h and group B included 1,355 patients treated with a combined prophylactic regimen of PCS and SCH. RESULTS: The diagnosis of PE was established in 69 patients by either high-probability ventilation perfusion scan, pulmonary angiogram, or autopsy. The incidence of PE in group A patients was 4% (48/1,196) and in group B was 1.5% (21/1,355). The concomitant use of bilateral PCS and SCH reduced the frequency of postoperative PE in 62% in comparison to the prophylaxis with SCH alone (p < 0.001). CONCLUSIONS: These data suggest that the combined prophylactic method of bilateral PCS and SCH is superior to SCH alone in the prevention of PE after cardiac surgery.

Aged↗
PubMed2003

Effect of elastic compression stockings on venous hemodynamics during walking.

PURPOSE: Venous hemodynamics evaluated during walking better reflect changes that occur under active physiologic conditions than do conventional static modes of exercise such as tip-toe exercise, knee bending, or dorsiflexion. We prospectively studied the efficacy of air-plethysmography (APG) in monitoring venous hemodynamics during ambulation, and with this method we determined the hemodynamic effects of graduated elastic compression stockings on the lower limb during walking at various speeds. METHODS: The residual volume fraction (RVF%) during treadmill walking was monitored with APG in 10 limbs with primary chronic venous insufficiency (CVI)(CEAP(2-4)) at four speeds (1.0, 1.5, 2.0 and 2.5 km/h consecutively), with and without elastic compression (21 mm Hg at the ankle). The method was validated in comparison with standard APG, which is based on tip-toe exercise. RVF obtained during treadmill walking at 1.5 km/h was correlated with RVF measured with standard APG in 30 subjects: 12 healthy volunteers, 11 patients with primary CVI, and 7 postthrombotic limbs. Data were analyzed with nonparametric statistics. RESULTS: RVF measurements during walking were reproduced with an intra-day coefficient of variation of 5.1% to 16.5%. RVF during walking correlated well with RVF during standard APG (tip-toe) (r = 0.5, P =.004). At each of the investigated walking speeds, stockings improved venous hemodynamics by decreasing RVF, from a median of 50.5% without stockings to 40.5% with stockings at 1.0 km/h (19.8% decrease), from 49% to 39.5% at 1.5 km/h (19.4% decrease), from 50.5% to 41% at 2.0 km/h (18.8% decrease), and from 53% to 45.5% at 2.5 km/h (14.2% decrease) (all speeds, P <.02). Efficacy of the stockings in decreasing RVF (percent change in RVF) was similar across the spectrum of examined speeds (P =.47). During walking with elastic stockings, nominal RVF values were also similar across the spectrum of walking speeds, except at 2.5 km/h (P =.012). During walking without stockings, RVF did not change with treadmill speed, nor did it differ from that obtained with conventional APG (tip-toe) (P =.46). The percentage decrease in RVF generated with elastic stockings correlated with the venous filling index (r = 0.73, P =.017) at 1.0 km/h. CONCLUSIONS: APG is a reproducible and valid method for monitoring venous hemodynamics during walking. Graduated elastic compression stockings significantly improved venous hemodynamics by reducing RVF in limbs with primary CVI at all examined walking speeds (1.0 to 2.5 km/h). The effect was linearly correlated with the amount of reflux (1.0 km/h). The modified application of APG during walking offers a new noninvasive method for assessment of venous hemodynamics in limbs with CVI, enabling quantification of the actual effect of elastic compression therapy during ambulation.

Adult↗
PubMed2001

Home use of impulse compression of the foot and compression stockings in the treatment of chronic venous insufficiency.

PURPOSE: The use of intermittent pneumatic compression, in addition to elastic bandages or stockings, accelerates the healing of leg ulcers in patients with severe chronic venous insufficiency (CVI). There is recent evidence that impulse compression of the plantar venous plexus reduces post-traumatic ankle swelling and prevents postoperative venous thromboembolism. The purpose of this study was to evaluate the clinical and hemodynamic responses after home use of impulse foot compression for 3 months in patients already using therapeutic compression stockings for the management of CVI. METHODS: Twelve extremities from 9 patients with documented CVI, class 4 to 5 according to the Clinical, Etiology, Anatomy, Pathophysiology classification system, were included in this prospective cohort study. All patients were instructed to use a foot pump device at home for 2 hours a day for 3 months in addition to therapeutic compression stockings (30-40 mm Hg) worn during the day. The device was set to three cycles (3 seconds) of compression (120 mm Hg) per minute. A clinical scoring system was completed before foot compression and 1, 2, and 3 months thereafter. In addition, all patients underwent air plethysmography studies at the same time intervals, including venous volume, venous filling index, ejection fraction, and residual volume fraction. RESULTS: Patients reported significant improvement in their scores for swelling (P <.05) and pain (P <.04). Air plethysmography showed a reduction in venous volume and venous filling index, although these differences were not significant. Ejection fraction remained unchanged and residual volume fraction was significantly reduced (P <.05) compared with baseline. The foot compression devices were well tolerated by all the patients in the study. CONCLUSIONS: The use of home foot impulse compression plus elastic stockings significantly reduced the residual volume fraction as measured by air-plethysmography in a group of patients with severe CVI. This favorable hemodynamic response could, in part, explain the clinical improvement achieved by this combined treatment. However, this represents a preliminary pilot study that needs to be confirmed in future randomized controlled studies with more patients included.

Bandages↗
PubMed1984

The efficacy of graduated compression stockings in the prevention of deep vein thrombosis after major gynaecological surgery.

The efficacy of graduated compression stockings in the prevention of deep vein thrombosis (DVT) after major gynaecological surgery was investigated in a controlled randomized prospective trial in 196 patients who were greater than 35 years of age. The stockings were worn by 104 of the 196 patients throughout their stay in hospital, the other 92 patients did not wear the stockings (control group). All the patients were scanned for DVT postoperatively with the 125I-labelled fibrinogen test. None of the 104 patients who wore the stockings developed a thromboembolism, but four of the 92 control patients who did not wear the stockings had DVT. This difference between the two groups was statistically significant.

Adult↗
PubMed1987

Effects of graduated compression stockings on blood lactate following an exhaustive bout of exercise.

To determine the effects of wearing graduated compression stockings (GCS) on the exercise response, twelve high fit males served as subjects in a series of two experiments. The first experiment consisted of six subjects performing two tests of maximal oxygen consumption (VO2 max) on a treadmill with and without GCS. The second experiment consisted of six subjects performing three separate three minute tests on a bicycle ergometer at 110% of their VO2 max. The experimental conditions for the three tests were: GCS worn during the test and recovery (GCS), GCS worn only during the test (GCS-O/O) and no stockings worn during either the test or recovery (NO-GCS). Oxygen consumption (VO2) was measured at rest, throughout the duration of all tests and during recovery in both experiments. Blood samples were obtained at rest and at 5, 15, 30, 45 and 60 minutes post exercise in the first experiment and at rest and at 5, 15 and 30 minutes post exercise in the second experiment for the determination of lactate and hematocrit. The use of GCS in the first experiment resulted in no significant difference in VO2 max, recovery VO2 or plasma volume shifts. Lactate values were lower throughout the duration of the recovery period with the 15 minute values being significantly different with the use of GCS. Significant differences in post exercise blood lactate values were found in the second experiment. The GCS trial resulted in significantly less lactate when compared to the GCS-O/O and the NO-GCS trials. There was no significant difference in post exercise lactate values between the NO-GCS and the GCS-O/O trials. Plasma volume changes were not significantly different among trials. Results of both experiments showed recovery lactate values to be lower with the use of GCS. These lower values are not ascribable to plasma volume shifts but rather appear to be due to an inverse gradient created by the GCS resulting in the lactate being retained in the muscular bed.

Adult↗
PubMedDate not supplied

The choice of compressive stocking.

Correct prescription of an elastic stocking necessitates a thorough acquaintance with the physiopathy of the disorder in question and also of the patient's psychological make up. Superficial venous pressure at the ankle when a patient presenting venous insufficiency walks, as is to be seen in the clinical picture, determines the strength of the compensatory compression of the stocking. The length of the stocking is determined by the spread of the disorder over the lower limb. The mensurations of the limb free of oedema determine the option of the stocking prescribed according to specific measurements and the stocking prescribed according to a standard series of measurements; it also determines the width and length of the latter. If a patient is obese or if his profession obliges him to stand for long, the choice will probably be of a high-compression stocking. The patient is consulted before thigh-stockings are prescribed. Before prescribing a stocking, the doctor must convince the patient that all other possibilities of treatment have been exhausted and that the compressive stocking is the only efficient support for his venous insufficiency. There ought to be as much care and caution in the choice and prescription of a medical compressive stocking as in the prescription of drugs.

Clothing↗
PubMed1995

Risk factors for leg ulcer recurrence: a randomized trial of two types of compression stocking.

Patients with recently healed leg ulceration were entered into a study of leg ulcer recurrence. In all, 188 patients [69% women, mean age = 72 (SD = 12) years] were entered into the study, of whom 166 were considered suitable for ready-made stockings and were randomized to one of two class II below-knee compression stockings and followed for at least 18 months. The remaining patients required either made-to-measure stockings (5) or could not tolerate stockings owing to friable skin and were treated by other methods (17). Overall cumulative recurrence rate was 26% after 1 year and 31% at 18 months. Independent risk factors for (RR = 2.34, p = 0.021) and unsuitability for stockings (RR = 2.52, p = 0.013). The randomized groups had similar stockings, 25 (15%) could not put their stockings on at all and 43 (26%) were only able to put them on with great difficulty. The two stocking types differed significantly in this regard when analysed for trend.

Aged↗
PubMed1998

Removal of dermal edema with class I and II compression stockings in patients with lipodermatosclerosis.

BACKGROUND: Lipodermatosclerosis is a sequela of deep venous insufficiency and a risk factor for the occurrence of venous leg ulceration. Medical compression stockings facilitate leg ulcer healing and prevent occurrence of ulcers resulting from removal of edema. Although the exact level of compression necessary for removal of dermal edema in patients with deep venous insufficiency has not been established, garments providing high compressive values of 30 to 40 mm Hg have been recommended. Dermal edema can be visualized by high-frequency ultrasonography. OBJECTIVE: We used ultrasound imaging to study whether a lower level of compression (class I 18 to 26 mm Hg vs class II 26 to 36 mm Hg) is effective in removal of dermal edema. This question is important because the use of hosiery with a lower compression class would enhance compliance and enable treatment of patients with mixed arteriovenous disease. METHODS: In 11 patients skin images were obtained with 20 MHz ultrasound from the malleolar region in lipodermatosclerotic skin and corresponding normal skin of the contralateral leg. The ratio of low echogenic pixel number to total pixel number (LEP/TP), which correlates with dermal water, was measured before and after 5 days of applied compression in two treatment courses where classes of compression were switched randomly. Ankle circumference was also measured. RESULTS: We found that LEP/TP was 33% higher in lipodermatosclerotic skin than in the matched normal skin indicating presence of skin edema. Application of class I and II compressive hosiery resulted in LEP/TP decrease by 17% (95% confidence interval, 0.07 to 0.26) and 14% (95% confidence interval, 0.04 to 0.21), respectively, suggestive of dermal edema reduction. No statistically significant difference in efficacy of dermal edema removal between class I and II was found. No changes in ankle circumference after application of both classes of compression was observed. CONCLUSION: Application of light and moderate compression results in a partial edema removal from the dermis in lipodermatosclerosis in the absence of measurable reduction in leg circumference. Class I compression is as effective as class II for elimination of dermal edema. These data indicate that light compression may be a useful modality for patients with deep venous insufficiency and lipodermatosclerosis who are not eligible for treatment with garments having higher compressive forces.

Adult↗
PubMed2003

Effect of graduated elastic compression stockings on leg symptoms and signs during exercise in patients with deep venous thrombosis: a randomized cross-over trial.

Graduated elastic compression stockings (ECS) are often prescribed after deep venous thrombosis (DVT) to alleviate acute symptoms and to prevent and treat post-thrombotic syndrome (PTS). In patients with DVT, leg symptoms tend to worsen with exercise. The effects of ECS use during exercise have not been studied. Objectives were to determine whether ECS improve symptoms and signs and increase exercise capacity when worn during treadmill exercise by patients with prior DVT, with or without PTS. The methods employed a randomized cross-over trial. We recruited subjects who had a first episode of unilateral DVT at least 1 year earlier and categorized them as having, or not having, the PTS using a validated scale. Subjects underwent two identical treadmill exercise sessions at least 1 week apart, and were randomly assigned to wear knee-length 30 mmHg ECS on the affected leg during one of the two sessions. Venous symptoms, leg volume, leg circumference and calf muscle flexibility were measured in the affected leg before and after both exercise sessions. Subjects achieved similar percentage maximum predicted heart rates during both sessions. Comparing the ECS to no ECS session, there were no significant differences in treadmill time (21.2 vs. 21.2 min, P = 0.94), gain in leg volume (71 vs. 73 mL, P = 0.83), or change in soleus or gastrocnemius flexibility, whether or not PTS was present. Symptoms in general worsened slightly with exercise regardless of whether or not ECS were worn and did not differ according to PTS status. Per-subject analysis showed that use of ECS resulted in global improvement of symptoms in 25% of subjects, global worsening in 33% of subjects, and had no or inconsistent effects in 42% of subjects. Whether or not PTS was present, the use of ECS during exercise by patients with prior DVT did not improve symptoms and signs during exercise or increase exercise capacity.

Adult↗
PubMed2003

Use of elastic compression stockings after deep venous thrombosis: a comparison of practices and perceptions of thrombosis physicians and patients.

Daily long-term use of elastic compression stockings (ECS) by patients with deep venous thrombosis (DVT) may help to prevent the post-thrombotic syndrome (PTS). However, the effectiveness of ECS in clinical practice is difficult to predict, since the practices and perceptions of patients and thrombosis physicians regarding ECS have not been documented. The objectives were to survey DVT patients and thrombosis physicians on their practices and perceptions regarding use of ECS after DVT, and to evaluate whether physician perceptions are supported by patient responses. Two surveys were conducted. The first was sent to 38 Canadian thrombosis physicians. The second was administered to 80 DVT patients attending Thrombosis Clinic at one of two Canadian university-affiliated hospitals. Most physicians believed that ECS were useful in preventing PTS and in managing venous symptoms. However, there was a lack of consensus regarding the optimal timing of initiation of ECS, duration of therapy, and compression strength, and only one-third routinely prescribed ECS to asymptomatic patients to prevent PTS. Most DVT patients who were prescribed ECS purchased them, 87% wore them daily, and most reported that ECS relieved swelling and symptoms. Physicians underestimated the degree of patient compliance with ECS, but correctly identified the main reasons for non-compliance. There is a lack of consensus among thrombosis physicians regarding ECS use after DVT. Patients with DVT are willing to comply with ECS therapy and most find them to be helpful. Our findings suggest that long-term study of the optimal use of ECS after DVT is both necessary and feasible.

Adult↗