Post-thrombotic syndrome and compression therapy

Aim

The aim of this review is to try to explain the controversy by critical analysis of published randomized controlled trials on the value of elastic compression stockings in the treatment of acute deep vein thrombosis in prevention of post-thrombotic syndrome.

Methods

A research was made through Medline and Embase databases to identify relevant original articles, with the following keywords: post-thrombotic syndrome, deep venous thrombosis, venous thromboembolism, compression stockings, prevention and compliance.

Results

We identified six randomized controlled trials. Brandjes et al. (1997) [2], Ginsberg et al. (2001) [3], Partsch et al. (2004) [4], Prandoni et al. (2004) [5], Aschwanden et al. (2008) [6], Kahn et al. (2014) [11]. Their conclusions and value are analyzed.

Conclusion

Prescription of elastic compression stockings for the prevention of post-thrombotic syndrome is now in doubt including long-term compression treatment. Two major issues remain: – We need randomized control trials with long-term outcome to determine if compression is effective to prevent post-thrombotic syndrome according to the precise location of the initial deep venous thrombosis. – Compliance is also a major issue. If compression is efficient how can we improve adherence.