Efficacy of Graded Elastic Compression in the Lower Leg

Pierson, Steve

doi:10.1001/jama.1983.03330260060033

Cited by 68 publications

(35 citation statements)

References 6 publications

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“…The effects of elastic compression stockings (ECS) following DVT have been well described, with such benefits as reduction in venous hypertension, decreased edema, and improvements in the tissue microcirculation. 28 Furthermore, the effectiveness of ECS in the prevention of PTS has been demonstrated in prospective randomized trials. 29,30 Additionally, when ECS are combined with early ambulation, rates of PTS are decreased.…”

Section: Effective Compression/ambulationmentioning

confidence: 99%

Prevention and treatment of the postthrombotic syndrome

Henke

2010

Journal of Vascular Surgery

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on behalf of writing group I of the Pacific Vascular Symposium 6, Ann Arbor, Mich TOPIC 1 Prevent recurrence of DVT Background. Recurrent ipsilateral deep venous thrombosis (DVT) is a primary and probably the most important etiologic factor in the development of the postthrombotic syndrome (PTS). 1,2Reducing the rate of recurrent DVT will thereby decrease the incidence of PTS. This can only be accomplished by modifying approaches to the current medical management of primary DVT. Furthermore, capitalizing on available strategies, such as patient and physician education, establishing hospital wide protocols for the prevention and treatment of DVT, and adherence to consensus guidelines, will help to optimize the treatment of DVT and thereby reduce the rate of recurrent DVT.The following issues are paramount to realizing a primary goal of recurrent DVT prevention (Table I): 1) identification of subgroups of patients who are at risk for recurrence, as DVT is heterogeneous with regard to anatomic extent, provoked by identified risk factors versus unprovoked, and cancer-versus non-cancer-related; 3,4 2) optimizing the initiation, duration, and type of anticoagulation for each patient, including maintaining appropriate intensity of oral anticoagulation; 5-7 3) provision of antithrombotic prophylaxis to high risk medical and surgical patients; 4,8,9 and 4) educating patients and front-line physicians regarding appropriate DVT management and risks of recurrent DVT. 10,11 Preventing recurrent DVT will also reduce the incidence of pulmonary embolism (PE) and PE-associated mortality. 12

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Section: Effective Compression/ambulationmentioning

confidence: 99%

Prevention and treatment of the postthrombotic syndrome

Henke

2010

Journal of Vascular Surgery

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“…Lower limb compression has been used to treat varicose veins since biblical times (Pierson 1983). Nowadays, compression stockings (knee and thigh length and full tights) are often first-line treatment for varicose veins, especially in primary care, even though evidence supporting their use is limited (Ramelet 2002;Tisi 2007).…”

Section: Description Of the Interventionmentioning

confidence: 99%

Compression stockings for varicose veins

Shingler

Robertson

Boghossian

et al. 2010

Cochrane Database of Systematic Reviews

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“…ECS provide graduated levels of compression (highest pressure at the ankle, lowest pressure at the knee or thigh) to assist the calf muscle and improve tissue circulation, although the exact mechanism is not well understood. 38,39 In general, the lower strength stockings are used for prevention or treatment of minor venous conditions, and the higher strength are used for more severe venous conditions (Table 2). …”

Section: Preventionmentioning

confidence: 99%

Contemporary Issues in the Prevention and Management of Postthrombotic Syndrome

et al. 2009

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OBJECTIVE To provide an evidence-based review and clinical summary of postthrombotic syndrome (PTS). DATA SOURCES A literature review was performed via MEDLINE (1950–July 1, 2009) and International Pharmaceutical Abstracts (1970–June 2009) searches using the terms post-thrombotic syndrome, post-phlebitic syndrome, deep vein thrombosis, and compression stockings. DATA SYNTHESIS PTS is best characterized as a chronic syndrome of clinical signs and symptoms including pain, swelling, parasthesias, and ulceration in the affected limb following deep vein thrombosis (DVT). It occurs in up to half of patients with symptomatic DVT, usually within the first 2 years. Although the pathophysiology of PTS is not well understood, a thrombus may cause venous hypertension and valvular incompetence resulting in edema, tissue hypoxia, and in severe cases, ulceration. Risk factors for PTS include recurrent ipsilateral DVT, obesity, and poor quality of anticoagulant therapy. PTS diagnosis is based on the presence of typical signs and symptoms and may be made using one of several clinical scoring systems. Prevention of PTS should focus on DVT prevention and the use of elastic compression stockings following DVT, while fibrinolysis remains under investigation as an effective method for PTS prevention. The treatment of PTS may include either pharmacologic or mechanical modalities, although none of these regimens has been rigorously tested. Pharmacists have the opportunity to provide more comprehensive antithrombotic management by educating patients and providers on PTS, recommending appropriate preventive therapy, assisting patients in obtaining and adhering to this therapy, and assisting providers with the management of PTS. CONCLUSIONS Providers should be proactive in preventing PTS, with pharmacists taking an active role in optimal DVT prevention, identifying patients at risk for PTS, and counseling and directing preventive therapies.

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Efficacy of Graded Elastic Compression in the Lower Leg

Cited by 68 publications

References 6 publications

Prevention and treatment of the postthrombotic syndrome

Prevention and treatment of the postthrombotic syndrome

Compression stockings for varicose veins

Contemporary Issues in the Prevention and Management of Postthrombotic Syndrome

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