scholarly journals Elastic compression stockings fail to prevent post-thrombotic syndrome after a first deep vein thrombosis

2014 ◽  
Vol 18 (1) ◽  
pp. 22-22 ◽  
Author(s):  
Abir Kanaan
Keyword(s):  
Deep Vein Thrombosis ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Deep Vein

Does prescription of medical compression prevent development of post-thrombotic syndrome after proximal deep venous thrombosis?

2015 ◽  
Vol 31 (3) ◽  
pp. 160-169 ◽  
Author(s):  
Michel Perrin ◽  
Bo Eklöf
Keyword(s):  
Deep Vein Thrombosis ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Vein Thrombosis ◽  
Randomized Controlled ◽  
Post Thrombotic Syndrome ◽  
Deep Vein

Aim The aim of this review is to try to explain the controversy by critical analysis of previously published randomized controlled trials on the value of elastic compression stockings in the treatment of acute proximal deep vein thrombosis in prevention of post-thrombotic syndrome, which forms the scientific basis for our present management. Methods A research was made through Medline and Embase databases to identify relevant original articles, not abstracts, with the following keywords: post-thrombotic syndrome, deep venous thrombosis, venous thromboembolism, compression stockings, prevention and compliance. Results We identified five randomized controlled trials (RCTs) before the SOX trial including 798 patients with acute proximal deep vein thrombosis. Brandjes (1997): at two years’ follow-up, elastic compression stockings reduced post-thrombotic syndrome by 50%; Ginsberg (2001): no difference in post-thrombotic syndrome with or without elastic compression stockings after more than two years’ follow-up; Partsch (2004): elastic compression stockings with routine above knee and early ambulation reduced the incidence and severity of post-thrombotic syndrome after two years’ follow-up; Prandoni (2004) showed significantly less post-thrombotic syndrome after elastic compression stockings for two years with a five-year follow-up; Aschwanden (2008) showed no difference with elastic compression stockings after three years’ follow-up. Conclusion Prescription of elastic compression stockings for the prevention of post-thrombotic syndrome is now in doubt. Immediate compression after diagnosis of acute deep vein thrombosis to prevent swelling and reduce pain, permitting early ambulation in combination with adequate anticoagulation has proven benefit, although a secondary analysis of the SOX trial refutes this belief. Continued long-term compression treatment is questioned. Two major questions remain: Is the lack of positive outcome on the development of post-thrombotic syndrome after proximal deep vein thrombosis due to the fact that there were a few patients with iliofemoral extension in the quoted randomized controlled trials who may benefit from prolonged medical compression treatment? Compliance is the major issue, and the two randomized controlled trials with excellent control of compliance showed significant reduction in the rate of post-thrombotic syndrome, but we know that in daily practice the adherence is closer to Kahn’s data.

Review on the value of graduated elastic compression stockings after deep vein thrombosis

2006 ◽  
Vol 96 (10) ◽  
pp. 441-445 ◽  
Author(s):  
Stavros Kakkos ◽  
Stella Daskalopoulou ◽  
Marios Daskalopoulos ◽  
Andrew Nicolaides ◽  
George Geroulakos
Keyword(s):  
Deep Vein Thrombosis ◽  
Preventive Measures ◽  
Number Needed To Treat ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Randomised Controlled ◽  
Deep Vein

SummaryGraduated elastic compression stockings (GECS) are commonly used in the primary prevention of deep vein thrombosis (DVT); however, their role in preventing recurrent DVT and also post-thrombotic syndrome is less well established. The aim of this review was to investigate the effect of GECS after DVT. A literature search was performed by two independent searchers in order to identify randomised controlled trials on the effect of GECS in preventing recurrent DVT and post-thrombotic syndrome. Four randomised trials, including 537 patients, were identified. Two of the studies demonstrated that below-knee GECS significantly reduced post-thrombotic syndrome during follow-up, while a smaller study showed equivocal results. GECS reduced the incidence of post-thrombotic syndrome from 54% to 25.2% [relative risk (RR) 0.47, 95% confidence interval (CI) 0.36-0.61] with the number needed to treat (NNT) being 4 (95% CI 2.7-5.0).The rate of recurrent asymptomatic DVT was also significantly reduced by GECS (RR 0.20, 95% CI 0.06-0.64; NNT 5); the reduction in symptomatic DVT was not significant (RR 0.79, 95% CI 0.50-1.26; NNT 34). In conclusion, there is level Ia evidence to suggest that GECS can significantly reduce the incidence of post-thrombotic syndrome (PTS) after DVT, and therefore these should be routinely prescribed. The evidence for recurrent DVT is less conclusive. Further research is needed towards standardising PTS diagnostic criteria and evaluating more effective preventive measures after DVT.

scholarly journals Iliofemoral deep vein thrombosis and the problem of post-thrombotic syndrome

2018 ◽  
Vol 17 (2) ◽  
pp. 99-103
Author(s):  
Nicholas Denny ◽  
◽  
Shreshta Musale ◽  
Helena Edlin ◽  
Jecko Thachil ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Compression Stockings ◽  
Short Term ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Catheter Directed Thrombolysis ◽  
Short Term Mortality ◽  
Considerable Morbidity ◽  
Deep Vein

Deep vein thrombosis (DVT) is an important cause of short-term mortality and long-term morbidity. Among the different presentations of DVT, thrombus in the iliofemoral veins may be considered the severest form. Although anticoagulation is the mainstay of the management of iliofemoral thrombosis, despite adequate anticoagulant treatment, complications including post-thrombotic syndrome is not uncommon. The latter is often overlooked but can cause considerable morbidity to the affected individuals. Preventing this condition remains a challenge but recent clinical trials of catheter directed thrombolysis and elasticated compression stockings provide some advance in this context. In this article, with the aid of a clinical case, we review the particular considerations to take into account when managing patients with an iliofemoral DVT.

Management of deep vein thrombosis to reduce the incidence of post-thrombotic syndrome

2010 ◽  
Vol 25 (1_suppl) ◽  
pp. 9-13 ◽  
Author(s):  
G D O Lowe
Keyword(s):  
Deep Vein Thrombosis ◽  
Compression Stockings ◽  
Inferior Vena Caval ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Oral Warfarin ◽  
Continued Use ◽  
Male Sex ◽  
Deep Vein ◽  
Active Cancer

The post-thrombotic syndrome (PTS) is the major chronic sequel of deep vein thrombosis (DVT) of the leg, and is a major socioeconomic challenge. In addition to systematic prophylaxis of DVT in hospitalized patients, effective management of DVT is important to reduce the incidence of PTS. Thrombolysis and thrombectomy are not indicated routinely. Optimal anticoagulation, usually with heparins initially and then with oral warfarin, is important to prevent recurrent DVT, which is a major risk factor for PTS. Following a routine three-month period of anticoagulation, patients with proximal idiopathic DVT should be individually assessed for the benefits and risks of continued oral anticoagulation, including patient preferences. Risk factors for recurrent DVT include active cancer, pregnancy, continued use of oral oestrogens, male sex, obesity, recurrent thrombosis, established PTS, permanent inferior vena caval filters, residual DVT, high fibrin D-dimer and other thrombophilias. Early walking, continued high levels of physical activity and wearing compression stockings for up to two years may also reduce the risk of PTS.

Elastic compression stockings for prevention of deep vein thrombosis

2010 ◽  
Author(s):  
Ashwin Sachdeva ◽  
Mark Dalton ◽  
Sachiendra V Amaragiri ◽  
Timothy Lees
Keyword(s):  
Deep Vein Thrombosis ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Vein Thrombosis ◽  
Deep Vein

scholarly journals Epidemioclinical profile and management of post thrombotic syndrome in Antananarivo

2020 ◽  
Vol 10 (6-s) ◽  
pp. 16-21
Author(s):  
TSIRIMALALA Rajaobelison ◽  
ZAKARIMANANA LUCAS Randimbinirina ◽  
RNAL Rakotorahalahy ◽  
AML Ravalisoa ◽  
AJC Rakotoarisoa
Keyword(s):  
Deep Vein Thrombosis ◽  
Anticoagulant Therapy ◽  
Varicose Veins ◽  
Previous History ◽  
Clinical Signs ◽  
Compression Stockings ◽  
Early Management ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Deep Vein

Introduction: The post-thrombotic syndrome (PTS) is the most complication of deep vein thrombosis who deserves an early management. The aim of this study was to determine the epidemio-clinical profile and the management of PTS. Methods: This was a retrospective and descriptive study for a period of 6 years from January 2013 to December 2018, performed at the Cardiovascular Surgery Unit in JRA Teaching Hospital Antananarivo, including all patients who presented post-thrombotic syndrome after an acute episode of deep venous thrombosis. Results: 106 patients were recorded among 315 patients who presented an episode of DVT (33.65%) and 14110 patients admitted in this period (0.75%). The average age was 46.18 years old. There were 30 males (28.30%) and 76 female (71.69%). The most important risk factors of PTS were previous history of varicose veins (50%), sedentary lifestyle (45.28%), insufficiency of anticoagulant therapy (68.86%) and proximal DVT (47.16%). Delayed of diagnosis were greater than or equal to 2 years after an acute DVT in 86 patients (81.13%). The most clinical signs were edema (56.60%) and varicose veins (54.71%). According the Villalta’s score, PTS were mild in 48 patients (45.28%), moderate in 47 patients (44.33%) and severe in 11 patients (10.37%). Management was lifestyles change (45.28%), compression stockings (100%), anticoagulant therapy (100%) and surgical treatment (65.09%). Conclusion: The frequency of PTS was 33.65% in our study. PTS reduces quality of life of patients, but it can be avoided if the treatments of DVT are adapted. Keywords: Deep vein thrombosis, Post-thrombotic syndrome, Epidemiology, Management

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