scholarly journals Individually tailored duration of elastic compression therapy in relation to incidence of the postthrombotic syndrome

2010 ◽  
Vol 52 (1) ◽  
pp. 132-138 ◽  
Author(s):  
Arina J. ten Cate-Hoek ◽  
Hugo ten Cate ◽  
Jan Tordoir ◽  
Karly Hamulyák ◽  
Martin H. Prins
Keyword(s):  
Compression Therapy ◽  
Postthrombotic Syndrome ◽  
Elastic Compression

scholarly journals Two divergent paths: compression vs. non-compression in deep venous thrombosis and post thrombotic syndrome

2017 ◽  
Vol 16 (4) ◽  
pp. 304-307
Author(s):  
Eduardo Simões Da Matta
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Plantar Flexion ◽  
Compression Therapy ◽  
Stiffness Index ◽  
Postthrombotic Syndrome ◽  
Static Stiffness ◽  
Valve Mechanism ◽  
Muscle Strengthening ◽  
Post Thrombotic Syndrome

Abstract Use of compression therapy to reduce the incidence of postthrombotic syndrome among patients with deep venous thrombosis is a controversial subject and there is no consensus on use of elastic versus inelastic compression, or on the levels and duration of compression. Inelastic devices with a higher static stiffness index, combine relatively small and comfortable pressure at rest with pressure while standing strong enough to restore the “valve mechanism” generated by plantar flexion and dorsiflexion of the foot. Since the static stiffness index is dependent on the rigidity of the compression system and the muscle strength within the bandaged area, improvement of muscle mass with muscle-strengthening programs and endurance training should be encouraged. Therefore, in the acute phase of deep venous thrombosis events, anticoagulation combined with inelastic compression therapy can reduce the extension of the thrombus. Notwithstanding, prospective studies evaluating the effectiveness of inelastic therapy in deep venous thrombosis and post-thrombotic syndrome are needed.

Compression in leg ulcer treatment: inelastic compression

2014 ◽  
Vol 29 (1_suppl) ◽  
pp. 146-152 ◽  
Author(s):  
Giovanni Mosti
Keyword(s):  
Ulcer Healing ◽  
Healing Rate ◽  
Great Majority ◽  
Compression Therapy ◽  
Venous Hypertension ◽  
Reduced Pressure ◽  
Elastic Compression ◽  
Venous Ulcers ◽  
Arterial Inflow ◽  
Pumping Function

Compression therapy is extremely effective in promoting ulcer healing. Which material to use, if elastic or inelastic, is still a matter of debate. This paper will provide an overview on the recent findings in compression therapy mainly for venous or mixed ulcers which are the great majority of leg ulcers. In this paper it will be demonstrated that inelastic compression has been proved to be significantly more effective than elastic compression in reducing venous reflux, increasing venous pumping function and decreasing ambulatory venous hypertension. In addition it is comfortable, well accepted by patients and achieved an extremely high healing rate in venous ulcers. With reduced pressure inelastic compression is able to improve venous pumping function in patients with mixed ulcers without affecting but improving the arterial inflow. It will be also clearly shown that studies claiming a better effect of elastic compression compared to inelastic in favouring healing rate have significant methodological flaws making their conclusions at least doubtful. In conclusion inelastic- is significantly more effective than elastic compression in reducing ambulatory venous hypertension which is the main pathophysiological determinant of venous ulcers and demonstrated to be very effective in getting ulcer healing. New multicentric, randomized and controlled studies, without methodological flaws, will be necessary to prove that elastic- is at least as effective as inelastic compression or, maybe, more effective.

scholarly journals Reduced incidence of vein occlusion and postthrombotic syndrome after immediate compression for deep vein thrombosis

Blood ◽  
2018 ◽  
Vol 132 (21) ◽  
pp. 2298-2304 ◽  
Author(s):  
Elham E. Amin ◽  
Ingrid M. Bistervels ◽  
Karina Meijer ◽  
Lidwine W. Tick ◽  
Saskia Middeldorp ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Compression Therapy ◽  
Postthrombotic Syndrome ◽  
Vein Thrombosis ◽  
Vein Occlusion ◽  
Absolute Reduction ◽  
Key Points ◽  
Deep Vein

Key Points Immediate compression therapy after DVT is associated with a 20% absolute reduction of RVO. The reduction of residual thrombosis is associated with an 8% absolute reduction of postthrombotic syndrome at 24 months.

The Post-Thrombotic Syndrome

Hematology ◽  
2010 ◽  
Vol 2010 (1) ◽  
pp. 216-220 ◽  
Author(s):  
Susan R. Kahn
Keyword(s):  
Risk Factors ◽  
Anticoagulation Therapy ◽  
Compression Therapy ◽  
Secondary Prophylaxis ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Venous Ulcers ◽  
Risk Determinants

AbstractThe post-thrombotic syndrome (PTS) is an important chronic complication of deep vein thrombosis (DVT). The present review focuses on risk determinants of PTS after DVT and available means to prevent and treat PTS. More than one-third of patients with DVT will develop PTS, and 5% to 10% of patients develop severe PTS, which can manifest as venous ulcers. PTS has an adverse impact on quality of life as well as significant socioeconomic consequences. The main risk factors for PTS are persistent leg symptoms 1 month after acute DVT, anatomically extensive DVT, recurrent ipsilateral DVT, obesity, and older age. Subtherapeutic dosing of initial oral anticoagulation therapy for DVT treatment may also be linked to subsequent PTS. By preventing the initial DVT and DVT recurrence, primary and secondary prophylaxis of DVT will prevent cases of PTS. Daily use of elastic compression stockings for 2 years after proximal DVT appears to reduce the risk of PTS; however, uncertainty remains regarding optimal duration of use, optimal compression strength, and usefulness after distal DVT. The cornerstone of managing PTS is compression therapy, primarily using elastic compression stockings. Venoactive medications such as aescin and rutosides may provide short-term relief of PTS symptoms. Further studies to elucidate the pathophysiology of PTS, to identify clinical and biological risk factors, and to test new preventive and therapeutic approaches to PTS are needed.

Open surgical treatment for postthrombotic syndrome

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 48-55 ◽  
Author(s):  
Christian-Alexander Behrendt ◽  
Franziska Heidemann ◽  
Henrik Christian Rieß ◽  
Edgar Kleinspehn ◽  
Tobias Kühme ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Surgical Techniques ◽  
Venous Drainage ◽  
Compression Therapy ◽  
Postthrombotic Syndrome ◽  
Vein Thrombosis ◽  
Venous Valves ◽  
Small Subgroup ◽  
Open Surgical Treatment ◽  
Deep Vein

The postthrombotic syndrome counts as a frequent long-term complication after deep vein thrombosis with approximately 20%–50% of affected patients after deep vein thrombosis. The earliest that diagnosis of postthrombotic syndrome can be made is 6 months after deep vein thrombosis. Most patients suffer from swelling and chronic pain. In all, 5%–10% of patients may even develop venous ulcers. The complex etiology consists of limited venous drainage because of chronic occlusions and secondary insufficiencies of venous valves inducing non-physiological venous reflux. Conservative management, first of all compression therapy, is of crucial importance in treatment of postthrombotic syndrome. Endovascular and open surgical techniques can additionally be used in a small subgroup of patients. Although rarely performed, this article illuminates the open surgical techniques in treatment of postthrombotic syndrome such as venous bypass surgery, valve repair and varicose vein surgery.

On the Relationship between Changes in the Deep Veins Evaluated by Duplex Sonography and the Postthrombotic Syndrome 12 Years after Deep Vein Thrombosis

1997 ◽  
Vol 77 (06) ◽  
pp. 1109-1112 ◽  
Author(s):  
U K Franzeck ◽  
I Schalch ◽  
A Bollinger
Keyword(s):  
Femoral Vein ◽  
Compression Therapy ◽  
Venous Ulcer ◽  
Duplex Sonography ◽  
Clinical Findings ◽  
High Rate ◽  
Postthrombotic Syndrome ◽  
Compression Stockings ◽  
Acute Thrombosis ◽  
Superficial Femoral Vein

SummaryIn a prospective study we performed color duplex ultrasonography to evaluate patency and valvular function of previous thrombosed veins 12 years after the acute thrombosis.Normal clinical findings were found in 64% of the patients, mild postthrombotic skin changes in 28%, and marked trophic changes in 5%; only 1 venous ulcer occurred.In 39 patients, 114 initially thrombosed vein segments were evaluated. Thirty-seven of 72 proximal segments were completely recanalized (23 with valvular incompetence) and 21 segments exhibited partial recanalization (19 with valvular incompetence). Superficial femoral vein segments were completely occluded in 19%, however, excellent collateralization was provided via the deep femoral vein. Thromboses of the posterior tibial vein demonstrated a high rate of recanalization with development of valvular incompetence in 52%.Whereas obstruction and valvular incompetence as single factors led to a postthrombotic leg in 8.5% and 33%, respectively, the most frequent cause for the development of the postthrombotic syndrome was the combination of reflux plus obstruction in the deep veins (50%).Compression therapy with elastic compression stockings is recommended for at least 5 years after the acute thrombosis.

Foam sclerotherapy with Enoxaparin prophylaxis in high-risk patients with postthrombotic syndrome

VASA ◽  
2013 ◽  
Vol 42 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Stefanie Reich-Schupke ◽  
Martin Doerler ◽  
Peter Altmeyer ◽  
Markus Stücker
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Anticoagulation Therapy ◽  
Compression Therapy ◽  
Treatment Session ◽  
Current Data ◽  
Postthrombotic Syndrome ◽  
Foam Sclerotherapy ◽  
Symptomatic Pulmonary Embolism ◽  
Risk Patients

Background: According to the current guidelines for sclerotherapy hypercoagulability and thrombophilia with or without deep venous thrombosis are seen as relative contraindication for this treatment. But often such patients have an indication for a sclerotherapy. Recommendations for additional anticoagulation for sclerotherapy are missing. Patients and methods: In this retrospective analysis (2009 - 2010), 54 patients with deep venous thrombosis and/or pulmonal embolism in their medical history that had had foam-sclerotherapy of truncal or tributary veins with Polidocanol 0.5 - 3 % without prior anticoagulation therapy were included. In addition to compression treatment (23 - 32 mmHg) for 3 weeks patients were treated with Enoxaparine 40 mg once a day for 3 days after sclerotherapy. Clinical and duplex controls were conducted before every treatment and 2 - 3 weeks after the last injection. Results: Sclerotherapy was done on one (30/54) or on both (24/54) legs. In 2/54 legs a truncal vein and in all patients tributaries were treated. The volume per treatment session averaged 3.3 ml foam (2 - 6 ml). The patients had undergone an average of 4.9 treatments (1 - 11); altogether 262 sessions. There were no cases of deep venous thrombosis or symptomatic pulmonary embolism. In 7/262 treatments (2.7 %) symptomatic localized phlebitis occurred and in 2/262 (0.8 %) patients an ascending phlebitis beyond the sclerotherapy region was observed. Conclusions: Based on current data, foam sclerotherapy can be regarded as safe in patients with anamnestic thromboembolism when co-treated with compression therapy (23 - 32 mmHg) and Enoxaparin 40 mg once per day for 3 days post sclerotherapy. The current study is the first with a standardized regime. In view of the limitations of this study there should be urther randomized controlled trials.

scholarly journals Mechanism of Action of Elastic Compression Therapy in Phlebolymphology

2021 ◽  
Vol 4 (4) ◽  
Keyword(s):  
Mechanism Of Action ◽  
Constant Pressure ◽  
Compression Therapy ◽  
Physical Structure ◽  
Elastic Compression ◽  
Venous Ulcers

Compression is the best therapy in the treatment of venous ulcers. The intensity of the bandage compression essentially depends on four factors: the physical structure and elastomeric properties of the bandage, the shape of the limb the bandage is applied to, the ability and experience of the doctor or nurse who applies it and the ability of the patient to deambulate [1, 2]. The development of construction technologies can help reduce the variability of inter- and intra-bandage tension: one of the most promising possibilities is the manufacturing of a vari-stretch elastomer, capable of exerting a relatively constant pressure regardless of limited variations in extension.

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