NEW YORK (Reuters Health) - Using below-knee elastic compression stockings after a proximal DVT can reduce the rate of post-thrombotic syndrome by about 50%, according to a report published in the Annals of Internal Medicine for August 17th.

Although compression stockings are often recommended by physicians to prevent post-thrombotic sequelae, few studies have actually assessed the effectiveness of stockings in this regard.

The new findings are based on a study of 180 patients who experienced a first episode of symptomatic proximal DVT that was treated with standard anticoagulant therapy. At hospital discharge, the subjects were randomized to wear or not wear compression stockings for 2 years. The subjects were followed for up to 5 years.

Forty-four of the 90 control subjects developed post-thrombotic sequelae compared with just 23 of the 90 stocking-treated subjects, lead author Dr. Paolo Prandoni, from the University Hospital of Padua in Italy, and colleagues note. Moreover, severe sequelae were less common among stocking wearers (3 cases) than in controls (10 cases).

All but one of the post-thrombotic events were confined to the first 2 years. Between 6 months and 2 years, the cumulative incidence of post-thrombotic syndrome was 46.7% in the control group and 22.2% in the stocking group. On multivariate analysis, stocking wearers were 51% less likely to develop the syndrome than non-wearers (p = 0.01)

"Early use of ready-made elastic stockings, which are relatively inexpensive, safe to use, and well tolerated, can substantially reduce" the risk of post-thrombotic sequelae after an acute episode, the investigators conclude.

In a related editorial, Dr. Jeffrey S. Ginsberg, from McMaster University in Hamilton, Ontario, Canada, comments that "this important study demonstrates the utility of stockings in the prevention of the post-thrombotic syndrome and reproduces the results of a previous similarly designed randomized trial."

Ann Intern Med 2004;141:249-256,314-315

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