Compression Stockings Didn't Stop Post-Clot Complication

Compression stockings did not prevent post thrombotic syndrome after deep leg vein clot

(RxWiki News) Compression stockings are designed to maintain pressure in the legs and to prevent swelling and clots, but a recent study showed they did not help with one problem.

After a patient has a clot in a deep leg vein, a complication called post-thrombotic syndrome (PTS) can occur. Minor to severe leg pain, leg swelling and skin changes can occur in PTS.

Wearing compression stockings to help prevent PTS is usually recommended, but this recent study found that they did not prevent PTS in people who had already had a deep leg vein clot.

"Tell your doctor if you've had a deep leg vein clot."

Susan R. Kahn, MD, from the Centre for Clinical Epidemiology at Jewish General Hospital in Montreal, Canada, led this research team.

Dr. Kahn and colleagues enrolled 806 people after they had had their first deep leg vein clot. The average age of the patients was 55.

The research team assigned 410 patients to wear compression stockings from waking until bedtime and encouraged them to be active. The remaining 396 patients wore stockings that were not compression stockings (placebo stockings).

The researchers followed up with the participants at 1, 6, 12, 18 and 24 months. At these visits, the patients were evaluated for occurrence and severity of PTS. A score, called a Villalta score, was applied to indicate severity. A score of 5 or greater or a presence of a leg vein ulcer suggested PTS; a score of 5 to 9 indicated mild PTS; a score of 10 to 14 was moderate PTS; and a score greater than 15 indicated severe PTS or leg vein ulcer.

Results of this research showed that about the same number of patients in each group got PTS. About 14 percent of the patients who wore compression stockings developed PTS and about 13 percent of the patients who wore placebo stockings developed PTS.

The severity of the PTS was also similar between the two groups. About 51 percent of each group had no PTS. Mild PTS was seen in 32 to 33 percent of each group. Moderate PTS was seen in 8 percent of compression stocking wearers and 11 percent of placebo stocking wearers. Severe PTS was seen in 8 percent of patients in the compression stocking group and 6 percent of the group wearing placebo stockings.

Dr. Kahn and team noted that 114 people did not complete the study due to dropping out, being lost to follow-up or by dying. However, similar numbers of these events were seen in each group.

The authors stated that their results did not support the wearing of compression stockings after a deep vein clot for prevention of post-thrombotic syndrome.

“Whether compression stockings might be of benefit to improve symptoms of established PTS or of acute DVT (deep vein clots) warrants assessment of future studies,” the authors wrote.

This study appeared in the March issue of The Lancet.

Funding for the research was provided by the Canadian Institutes of Health Research.

The authors declared no conflicts of interest.

Review Date: 
March 11, 2014