Compression Stockings May Not Reduce Post Thrombotic syndrome in DVT Patients

MedicalResearch.com Interview with:

Riyaz Bashir MD, FACC, RVT Professor of Medicine Director, Vascular and Endovascular Medicine Department of Medicine Division of Cardiovascular Diseases Temple University Hospital Philadelphia, PA 19140

Dr. Riyaz Bashir

Riyaz Bashir MD, FACC, RVT
Professor of Medicine
Director, Vascular and Endovascular Medicine
Department of Medicine
Division of Cardiovascular Diseases
Temple University Hospital
Philadelphia, PA 19140

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Bashir: The use of compression stockings in the prevention of post thrombotic syndrome following an episode of deep vein thrombosis is common in clinical practice. However, the evidence to suggest its efficacy has been put into question by the recent publication of the SOX trial. Since this was the largest randomized controlled trial to date addressing this issue, it has led to clinicians questioning whether compression stockings should be used at all in these patients.

The main finding of this meta-analysis was that in patients with deep venous thrombosis, use of elastic compression stockings does not significantly reduce the development of post thrombotic syndrome. However the current body of evidence is limited and we believe at present it is too early to give up on the use of this therapy, which may benefit many subgroups of patients.

MedicalResearch.com: What should readers take away from your report?

Dr. Bashir: The take away message is that at this time there does not exist sufficient data to show that use of compression therapy is not beneficial. Clinicians need to individualize the use of this therapy based on the response each patient has had after using these stockings.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Bashir: This study also highlights the fact that there is a real need for new and more effective therapies for the treatment and prevention of post-thrombotic syndrome. This need is further emphasized by the fact that a large proportion of patients go on to develop post thrombotic syndrome despite using elastic compression stockings and in many patients who benefit from elastic compression stockings, the benefit is restricted to relief of symptoms rather than a cure of underlying disorder. We believe that there is a critical need for continued conduct of randomized controlled trials addressing this issue in a more pragmatic and patient centered fashion. 

MedicalResearch.com: Is there anything else you would like to add?

Dr. Bashir: Deep vein thrombosis is widely prevalent and affects about 300 000–600 000 people every year in the USA alone. Among all patients with deep vein thrombosis, roughly half go on to develop long-term complications such as swelling, discomfort, discoloration, and chronic ulcerations, the so-called post thrombotic syndrome.  These symptoms are often debilitating and cause substantial impairment in quality of life,  an increase in psychological stress, and reduced workplace productivity. Additionally the annual economic burden of post thrombotic syndrome is estimated to be greater than US$200 million in the USA alone. Therefore, prevention of post thrombotic syndrome after an episode of deep vein thrombosis is crucial both from an individual and a societal perspective.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Effect of compression stockings on post thrombotic syndrome in patients with deep vein thrombosis: a meta-analysis of randomised controlled trials

Subbiah, Rajeeve et al.
The Lancet Haematology , Volume 0 , Issue 0 ,
DOI: http://dx.doi.org/10.1016/S2352-3026(16)30017-5
Published Online: 05 May 2016

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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