The aim of this study was to illustrate how compression is performed worldwide in proximal DVT and if compression management has changed recently.
Methods
A global online survey, consisting of 36 questions, was used. The survey was solicited from membership lists of Union Internationale de Phlébologie (UIP) membership societies. For differences between the continents in comparison to Western Europe odds ratios and 95% Confidence Intervals (95%CI) where calculated.
Results
We received 626 answers from 41 countries. Compression is routinely used in proximal DVT in all regions (82.8%). 81.4% start compression immediately after diagnosis. In the acute phase of DVT reduction of pain and swelling (91.7%) and PTS prevention (66.2%) are the main reasons for compression. 33.2% recently changed their compression management with 43.5% starting compression earlier and 7.0% later.
Conclusions
Compression is still used routinely in proximal DVT in addition to anticoagulation. The changes in international guidelines towards the non-routine use of compression in proximal DVT have not caused significant changes in DVT management.
NaessIAChristiansenSCRomundstadP, et al.
Incidence and mortality of venous thrombosis: a population-based study. J Thromb Haemost2007;
5: 692–699.
2.
PrandoniPKahnSR.Post-thrombotic syndrome: prevalence, prognostication and need for progress. Br J Haematol2009;
145: 286–295.
3.
BergqvistDJendtegSJohansenL, et al.
Cost of long-term complications of deep venous thrombosis of the lower extremities: an analysis of a defined patient population in Sweden. Ann Intern Med1997;
126: 454–457.
4.
KearonCKahnSRAgnelliG, et al.
Antithrombotic therapy for venous thromboembolic disease: American college of chest physicians evidence-based clinical practice guidelines (8th edition). Chest2008;
133: 454S–4545.
5.
BrandjesDBüllerHRHeijboerH, et al.
Randomised trial of effect of compression stockings in patients witch symptomatic proximal-vein thrombosis. Lancet1997;
349: 759–762.
6.
PrandoniPFrullaMMarchioriA, et al.
Below-Knee elastic compression stockings to prevent the post-thrombotic syndrome: a randomized controlled trial. Ann Intern Med2004;
141: 249–256.
7.
KahnSRShapiroSWellsPS, et al.; SOX trial investigators.Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial. Lancet2014;
383: 880–888.
8.
KearonCAklEAOrnelasJ, et al.
Antithrombotic therapy for VTE disease. Chest2016;
149: 315–352.
9.
PartschBPannierFPartschH, et al.
Kompressionsstrümpfe nach tiefer beinvenenthrombose im internationalen vergleich. Vasomed2005;
17: 82–87.
10.
KahnSRElmanERodgerMA, et al.
Use of elastic compression stockings after deep venous thrombosis: a comparison of practices and perceptions of thrombosis physicians and patients. J Thromb Haemost2003;
1: 500–506.
11.
BlättlerWGerlachHE.Implementation of outpatient treatment of deep-vein thrombosis in private practices in Germany. Eur J Vasc Endovasc Surg2005;
30: 319–324.
12.
BlättlerWPartschH.Leg compression and ambulation is better than bed rest for the treatment of acute deep venous thrombosis. Int Angiol2003;
22: 393–400.
13.
PartschH.Ambulation and compression after deep vein thrombosis: dispelling myths. Semin Vasc Surg2005;
18: 148–152.
14.
RabeEPartschHHafnerJ, et al.
Indications for medical compression stockings in venous and lymphatic disorders: an evidence-based consensus statement. Phlebology2018;
33: 163–184.
15.
PartschHBlättlerW.Compression and walking versus bed rest in the treatment of proximal deep venous thrombosis with low molecular weight heparin. J Vasc Surg2000;
32: 861–869.
16.
Roumen-KlappeEMden HeijerMvan RossumJ, et al.
Multilayer compression bandaging in the acute phase of deep-vein thrombosis has no effect on the development of the post-thrombotic syndrome. J Thromb Thrombolysis2009;
27: 400–405.
17.
KahnSRShapiroSDucruetT, et al.
Graduated compression stockings to treat acute leg pain associated with proximal DVT. A randomised controlled trial. Thromb Haemost2014;
112: 1137–1141.
KahnSR.Measurement properties of the Villalta scale to define and classify the severity of the post-thrombotic syndrome. J Thromb Haemost2009;
7: 884–888.
20.
KahnSRPartschHVedanthamS, et al.; Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis.
Definition of post-thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization. J Thromb Haemost2009;
7: 879–883.
21.
MusaniMHMattaFYaekoubAY, et al.
Venous compression for prevention of postthrombotic syndrome: a meta-analysis. Am J Med2010;
123: 735–740.
22.
LabropoulosNGasparisAPCapriniJA, et al.
Compression stockings to prevent post-thrombotic syndrome. Lancet2014;
384: 129–130.
23.
Ten Cate-HoekAJ.Elastic compression stockings – is there any benefit?Lancet2014;
383: 851–853.
24.
BenigniJSadounSAllaertF, et al.
Comparative study of the effectiveness of class 1 compression stockings on the symptomatology of early chronic venous disease. Phlebologie2003;
56: 117–125.
25.
VayssairatMZianiEHouotB.Placebo controlled efficacy of class 1 elastic stockings in chronic venous insufficiency of the lower limbs. J Mal Vasc2000;
25: 256–262.
26.
TieHTLuoMZLuoMJ, et al.
Compression therapy in the prevention of postthrombotic syndrome: a systematic review and Meta-analysis. Medicine (Baltimore)2015;
94: e1318.
27.
ArpaiaGCimminielloCMastrogiacomoO, et al.
Efficacy of elastic compression stockings used early or after resolution of the edema on recanalization after deep venous thrombosis: the COM.PRE trial. Blood Coagul Fibrinolysis2007;
18: 131–137.
28.
PartschHKaulichMMayerW.Immediate mobilisation in acute vein thrombosis reduces post-thrombotic syndrome. Int Angiol2004;
23: 206–212.
29.
AminEEBistervelsIMMeijerK, et al.
Reduced incidence of vein occlusion and postthrombotic syndrome after immediate compression for deep vein thrombosis. Blood2018;
132: 2298–2304.
30.
AminEEJooreMATen CateH, et al.
Clinical and economic impact of compression in the acute phase of deep vein thrombosis. J Thromb Haemost2018;
16: 1555–1563.
31.
Ten Cate-HoekAJAminEE, et al.
Individualised versus standard duration of elastic compression therapy for prevention of post-thrombotic syndrome (IDEAL DVT): a multicentre, randomised, single-blind, allocation-concealed, non-inferiority trial. Lancet Haematol2018;
5: 25–33.
32.
MolGCvan de ReeMAKlokFA, et al.
One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial. Bmj2016;
353: i2691.
33.
PrandoniPNoventaFQuintavallaR, Canano Investigatorset al.
Thigh length versus below-knee compression elastic stockings for prevention of the postthrombotic syndrome in patients with proximal-venous thrombosis: a randomized trial. Blood2012;
119: 1561–1565.
34.
RajuSHollisKNeglenP.Use of compression stockings in chronic venous disease: patient compliance and efficacy. Ann Vasc Surg2007;
21: 790–795.
