Two layers of graduated compression stockings can reduce healthy saphenous vein diameters in the standing position

Abstract

Background Previous studies reported graduated compression stockings can reduce the calibre of deep veins in the standing subjects. However, the literature has been inconclusive on the effect of graduated compression stockings on superficial veins in standing subjects. Objectives To assess the effect of two layers of graduated compression stockings on the diameter of saphenous veins in healthy subjects. Materials and methods In 17 legs of nine healthy subjects, we studied the effect of single layering and double layering of graduated compression stockings (23–32 mmHg, Thigh High Belted Sigvaris, Switzerland) on the diameter of the great saphenous vein mid-thigh, great saphenous vein mid-calf and small saphenous vein mid-calf. The measurements were taken using duplex ultrasound (Toshiba Aplio XG 500, 18-7 MHz transducer), through the fabric using a generous amount of ultrasound gel, on subjects both supine or prone and standing. Results Two layers of Class II graduated compression stockings reduced the calibre of great saphenous vein mid-thigh from (4.1 mm to 3.3 mm, p < 0.05), great saphenous vein mid-calf (2.8 mm to 2.2 mm, p < 0.01) and small saphenous vein (2.7 mm to 1.9 mm, p < 0.01) in the standing position. In the supine or prone position, great saphenous vein showed narrowing but there was no measurable change in the calibre of the small saphenous vein. The degree of narrowing was measurable, but insufficient to approximate the vein walls. Conclusion Superimposition of two Class II graduated compression stockings reduced the calibre of the saphenous veins in the standing position but did not approximate the vein walls. In the supine or prone position, the addition of a second layer of graduated compression stockings did not result in further narrowing of the saphenous veins.

Treatment of venous malformations with tumescent-assisted sclero-embolic and ablative lasers (SEALs): Safe and effective long-term outcomes

“…[15][16][17] The approximation effect is especially important as external compression with compression stockings or garments is unable to achieve significant vessel calibre reduction of superficial veins. 18,19 While the efficacy of TA has been well-demonstrated in the treatment of lower limb leg veins, its effect on VMs has not been described. Considering that VMs, compared to 'normal' veins, possess defective vessel walls, 20 one cannot afford to imply same conventional concept tumescentassisted SEALs established on 'normal' veins in the management of VMs.…”

“…15–17 The approximation effect is especially important as external compression with compression stockings or garments is unable to achieve significant vessel calibre reduction of superficial veins. 18,19…”

Endovascular repair of the aorta: stentgraft deformation matters

“…To improve the outcomes of EVAR in general, we first need to improve our understanding of the behavior of the different stentgrafts. Several factors may influence the durability of these treatments, among which the cardiac cycle, the respiratory cycle, the body position and posture, blood flow and the composition of blood and the vascular wall 18,19,[73][74][75][76][77][78][79] . These factors may influence, or may be influenced by, stentgraft deformation.…”

“…The femoral vein diameter and CSA reduced in TB, knee flexion (sitting position), leg elevation, upright position and hip flexion compared to a supine position [67][68][69][70][71][72][73][74][75] . The great saphenous vein, tibial vein and small saphenous vein diameter and CSA increased in upright and R-TB positions compared to supine and prone positions [75][76][77][78][79][80]86 . Only Yang et al 78 did not find measurable differences in tibial vein and small saphenous vein diameters in upright position compared to prone and supine positions (n = 9).…”

“…The great saphenous vein, tibial vein and small saphenous vein diameter and CSA increased in upright and R-TB positions compared to supine and prone positions [75][76][77][78][79][80]86 . Only Yang et al 78 did not find measurable differences in tibial vein and small saphenous vein diameters in upright position compared to prone and supine positions (n = 9). Popliteal vein diameter and CSA were larger in upright or sitting positions than in supine and prone position, and in postures with leg elevation 70,81,82 or leg flexion 83 , but did not differ between standing and kneeling positions 84,85 .…”