Clinical research studyVenous Compression for Prevention of Postthrombotic Syndrome: A Meta-analysis
Section snippets
Study Identification
We attempted to identify all published trials in all languages that used compression stockings to prevent the postthrombotic syndrome. Studies were identified by searching PubMed through June 2009. Key words in the literature search were: “postthrombotic syndrome” combined with “prevention,” “elastic stockings,” or “compression therapy.” We augmented our searches by manually reviewing the reference lists of all original articles and all review articles. This was done by 2 of the authors,
Results
Age and sex of the patients in the 5 included trials are shown in Table 1. Among 338 treated patients, below-knee stockings were used in 308 (91%) patients, thigh-length stockings in 17 (5%), and thigh bandages in 13 (4%).2, 3, 4, 5, 6 Characteristics of the stockings, time interval between diagnosis of deep venous thrombosis and application of stockings, duration of stocking use, duration of follow-up, the scoring system used, and the incidence of postthrombotic syndrome are shown in Table 2.
Discussion
The risk of postthrombotic syndrome, on average, was reduced 46% by venous compression, usually by below-knee compression stockings. Venous compression was more effective in reducing the incidence of severe postthrombotic syndrome (62% risk reduction) than mild-to-moderate postthrombotic syndrome (48% risk reduction). One investigation (Ginsberg et al)3 showed little benefit. In this investigation, the control patients received stockings that were 1-2 sizes too large.3 We speculate that the
Acknowledgment
We thank Muhammad Anis Musani, MD, for assisting in the literature search.
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2019, Thrombosis ResearchCitation Excerpt :Until recently, graduated elastic compression stockings were prescribed to prevent PTS in adults at risk [2]. Supporting their use, a pooled analysis of randomized controlled trials (RCT) conducted between the 1990s and the early 2000s [3–7] concluded that compression stockings reduced the incidence of PTS by 50% [8]. Despite their heterogeneity (e.g., type and pressure of the stockings, time to intervention, length of follow up), the studies showed a lower absolute frequency of PTS in patients assigned to the stockings garment arm.
Funding: None.
Conflict of Interest: None of the authors have any financial or other potential conflicts of interest relative to the data in this manuscript.
Authorship: All authors had access to the data and a role in writing the manuscript.