Compression reduces post-thrombotic syndrome risk by half
MedWire News: Compression with stockings or bandages may halve the risk for post-thrombotic syndrome, say researchers, although the timing and duration of such treatment is yet to be determined.
Outlining the need for their study, Paul Stein (Michigan State University, Pontiac, USA) and colleagues write: "Mild-to-moderate post-thrombotic syndrome occurs in 37% of patients with deep venous thrombosis, with severe syndrome seen in 12% of patients."
Graduated compression stockings are now commonly used for patients with deep vein thrombosis to prevent post-thrombotic syndrome, but the clinical evidence to date has not been entirely consistent.
Stein and team therefore performed a systematic literature review and identified five randomized trials that reported outcomes in 580 patients with deep vein thrombosis, 296 of whom received venous compression treatment.
As reported in The American Journal of Medicine, mild-to-moderate post-thrombotic syndrome occurred in 22% of patients given venous compression and 37% of those who were not. Severe post-thrombotic syndrome affected 5% of patients given compression therapy and 12% of those who did not receive such treatment. Of note, the risk for post-thrombotic syndrome of any severity was 26% in those given compression therapy and 46% in those who were not.
The authors note that venous compression most commonly involved below-the-knee stockings. Interestingly, previous research has failed to establish a link between below-the-knee stockings and the risk for post-thrombotic syndrome. However, Stein and co-workers note that in this previous study, the stockings used were one or two sizes too large for the patients and compression treatment did not start for 1 year after the onset of deep-vein thrombosis, which could account for the lack of treatment benefit.
Other studies have varied in terms of the type of compression device used, when they were employed, and for how long they were used, the authors write.
Concluding, the researchers suggest that, "although the use of venous compression in patients with deep vein thrombosis would seem to be indicated for reducing the incidence of post-thrombotic syndrome, there was wide variability in the methods employed and further investigation, therefore, is needed."
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By Philip Ford