COMPRESSION STOCKINGS SKIN
COMPRESSION STOCKINGS TRIAL

34 In another prospective randomized study, compression therapy and ambulation in the first 10 days from the acute thrombotic event were associated with benefit in mean Villalta scores, even after a secondary treatment with compression therapy for 2 years.

COMPRESSION STOCKINGS TRIAL

33 Lack of compliance to compression therapy (55.6% of patients compared to 90% in the previous trials) and patient characteristics, such as the initiation and duration of anticoagulation and the advent of the newer oral thrombin and factor Xa inhibitors, may have affected the results of the SOX trial compared to previous studies. No statistically significant difference in the incidence of PTS (Ginsberg and Villalta PTS scores) between the two groups was found at a 2 year follow-up. In a recent multicenter randomized placebo-controlled trial (SOX: Compression Stockings to Prevent the Post-Thrombotic Syndrome after Symptomatic Proximal Deep Vein Thrombosis), 33 410 patients with proximal DVT were randomized to gradient compression stockings (class 3) versus placebo (noncompression hosieries). In two prospective randomized trials, 31,32 a statistically significant 50% PTS absolute risk reduction was found in patients with a first episode of proximal deep vein thrombosis (iliac, femoral, and popliteal vein) who wore a class 3 compression stocking for 2 years. 30 Gradient compression stockings can potentially reduce the risk of PTS by counteracting this basic pathogenetic mechanism.

COMPRESSION STOCKINGS SKIN

The pathogenesis of PTS is complex and includes a postthrombotic inflammatory reaction involving the venous wall and valves with subsequent remodeling, development of venous hypertension, varicose veins, skin changes, and ultimately venous ulcers. 29 Approximately 33% of the population with DVT/PE will develop a recurrence within 10 years, and 20% to 50% of those patients will experience long term complications such as post-thrombotic syndrome (PTS).

Recent data from the Centers for Disease Control and Prevention estimates that as many as 900,000 people (1-2 per 1,000) are affected by deep vein thrombosis (DVT) and pulmonary embolism (PE), with estimates of 60,000 to 100,000 patients dying from these diseases in the United States. Sidawy MD, MPH, in Rutherford's Vascular Surgery and Endovascular Therapy, 2019 Gradient Compression Stockings and Prevention of Postthrombotic Syndrome in Acute Deep Vein Thrombosis.

Compression stockings