scholarly journals Evaluating the Role of Compression Stockings in Preventing Post thrombotic Syndrome: A Review of the Literature

Thrombosis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Abir O. Kanaan ◽  
Jayne E. Lepage ◽  
Shabdis Djazayeri ◽  
Jennifer L. Donovan

Background. Postthrombotic syndrome (PTS) is a burdensome and costly complication of deep vein thrombosis (DVT). Up to 50% of patients with DVT will develop the disease within two years following the diagnosis of acute DVT. Various risk factors for developing PTS have been identified and different modalities have been used to prevent its development. Compression stockings have been studied for the prevention of PTS in patients diagnosed with proximal DVT. Methods. MEDLINE and EMBASE databases were searched to identify relevant original articles. Results. Several trials including two metaanalyses have examined the role of compression stockings for the prevention of PTS. Although most trials showed significant reduction in the development of PTS with the use of compression stockings, limitations in study design prevent the generalizability of the data. Two studies supported an individualized tailored duration especially in patients at low risk for developing the syndrome. A randomized double-blind placebo-controlled trial involving 800 patients is currently ongoing and may confirm the results of older studies. Conclusions. Clinical trials support the use of compression stockings in patients diagnosed with proximal DVT for the prevention of PTS.

1984 ◽  
Vol 51 (01) ◽  
pp. 071-074 ◽  
Author(s):  
S L Blarney ◽  
B M McArdle ◽  
P Burns ◽  
D C Carter ◽  
G D O Lowe ◽  
...  

SummaryFibrinolytic shutdown may be important in the development of postoperative deep vein thrombosis (DVT). We have previously shown that stanozolol 50 mg, given intramuscularly 24 hr before surgery, prevents the decrease in plasminogen activator activity (PA) seen on the first postoperative day in patients at high risk of DVT. To investigate the role of fibrinolytic shutdown in causation of DVT, sixty patients were randomised in a double-blind controlled trial to receive stanozolol or placebo intramuscularly, and DVT was detected by leg scanning and confirmed by venography. Scan positive DVT occurred in IT of 31 placebo patients (35%) and 12 of 29 who received stanozolol (41%). A significant decrease in PA was confirmed in the placebo group, while stanozolol caused a significant increase in PA on the first postoperative day. Patients in either group who did not develop DVT showed minimal changes in PA. We conclude that prevention of fibrinolytic shutdown by this regimen of stanozolol does not prevent postoperative DVT, and that further studies are required to clarify the relationships of postoperative fibrinolysis and DVT.


1992 ◽  
Vol 67 (02) ◽  
pp. 203-208 ◽  
Author(s):  
Giancarlo Agnelli ◽  
Benilde Cosmi ◽  
Paolo Di Filippo ◽  
Valeria Ranucci ◽  
Franca Veschi ◽  
...  

SummaryDermatan sulphate (MF 701) is a natural glycosaminoglycan that catalyses thrombin inhibition by heparin cofactor II. The aim of the study was to evaluate the efficacy and safety of MF 701 for prevention of deep vein thrombosis (DVT) in patients with hip fracture. A randomised, double-blind, placebo-controlled design was used to assess two dose regimens of MF 701 in two consecutive study phases. Treatment was started within 48 h from the trauma and continued for 14 days for non-operated patients or until the 10th postoperative day. Bilateral mandatory venography was used to assess the end-point. Eighty patients were included in the first phase (40 MF 701, 40 placebo). MF 701, 100 mg IM b. i. d., did not reduce incidence of DVT from that on placebo and did not induce any bleeding. In the second phase 126 patients were included, with a randomisation ratio of 2:1 (84 MF 701, 300 mg IM b.i.d., 42 placebo). Bilateral venography was obtained for 110 patients. The incidence of DVT was 64% (23/36) in the placebo group and 38% (28/74) in the MF 701 group (p = 0.01; odds ratio [OR] = 0.34, 95% confidence limits [CL] = 0.15-0.80); proximal DVTs were 42% (15/36) and 20% (15/74), respectively (p = 0.02; OR = 0.36, CL = 0.15-0.89). No significant differences were found in haemorrhagic complications (2.4% in each group), blood loss from drains, blood transfusions, haemoglobin and haematocrit values. This study is the first demonstration that dermatan sulphate is a clinically effective antithrombotic agent without bleeding effects. It also provides evidence of the biological role of heparin cofactor II.


2016 ◽  
Vol 3 (12) ◽  
pp. e556-e562 ◽  
Author(s):  
Marc Righini ◽  
Jean-Philippe Galanaud ◽  
Hervé Guenneguez ◽  
Dominique Brisot ◽  
Antoine Diard ◽  
...  

The Prostate ◽  
2019 ◽  
Vol 79 (6) ◽  
pp. 614-621 ◽  
Author(s):  
Young Hyo Choi ◽  
Deok Hyun Han ◽  
Seon‐woo Kim ◽  
Min‐Ji Kim ◽  
Hyun Hwan Sung ◽  
...  

1981 ◽  
Vol 26 (1_suppl) ◽  
pp. S81-S83 ◽  
Author(s):  
P. E. Jarrett

The postphlebitic syndrome is a result of previous deep vein thrombosis and presents with oedema, pain, induration, pigmentation and ulceration. Extravascular deposition of fibrin is associated with reduced fibrinolytic activity in these patients. In a double-blind crossover study there was evidence of benefit from stanozolol which enhanced fibrinolytic activity. No side effects of any consequence were noted with a dosage of 5 mg twice per day.


Blood ◽  
2018 ◽  
Vol 131 (20) ◽  
pp. 2215-2222 ◽  
Author(s):  
Anat Rabinovich ◽  
Susan R. Kahn

Abstract The postthrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT) that imposes significant morbidity, reduces quality of life, and is costly. After DVT, 20% to 50% of patients will develop PTS, and up to 5% will develop severe PTS. The principal risk factors for PTS are anatomically extensive DVT, recurrent ipsilateral DVT, obesity, and older age. By preventing the initial DVT and DVT recurrence, primary and secondary prophylaxis of DVT will reduce occurrence of PTS. The effectiveness of elastic compression stockings (ECSs) for PTS prevention is controversial. Catheter-directed thrombolysis is not effective to prevent PTS overall but may prevent more severe forms of PTS and should be reserved for select patients with extensive thrombosis, recent symptoms onset, and low bleeding risk. For patients with established PTS, the cornerstone of management is ECS, exercise, and lifestyle modifications. Surgical or endovascular interventions may be considered in refractory cases. Because of a lack of effective therapies, new approaches to preventing and treating PTS are needed. This article uses a case-based approach to discuss risk factors for PTS after DVT, how to diagnose PTS, and available means to prevent and treat PTS, with a focus on new information in the field.


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