Compression Stockings Keep DVT Complications at Bay
MONDAY, Aug. 16 (HealthDayNews) -- Managing DVT, a potentially dangerous blood clot that develops in the inner veins of your legs, might be as simple as slipping on a pair of stockings.
New Italian research suggests that wearing elastic compression stockings appears to reduce the chance of developing complications for up to two years.
"The group that got stockings had a lower incidence of post-thrombotic syndrome than those who didn't," explained Dr. Jeffrey S. Ginsberg, author of an editorial that accompanies the study. Both appear in the Aug. 17 issue of the Annals of Internal Medicine.
Some of those with deep vein thrombosis (DVT) develop complications which can range from the relatively benign (painless swelling of the leg) to incapacitating (chronic pain and leg sores). In the worst cases, DVT can progress to a life-threatening pulmonary embolism, where a blood clot breaks free and enters the lungs. All of these problems, which stem from impaired blood flow in the leg, can arise even if the individual is being treated for the clot.
As many as 2 million Americans are affected by DVT each year, according to the American Heart Association.
While doctors have long recommended that patients wear elastic compression stockings to prevent complications, there is little scientific evidence to support the advice. That fact and the inconvenience of the stockings (they can be expensive, hot and hard to put on), means they are not widely used.
The support stockings work by exerting firmer pressure on the bottom of the leg and less pressure at the top so as to improve blood flow up to the heart. They are available in medical supply stores for $30 to $50.
This study randomized 180 patients with a first episode of DVT either to wear compression stockings below the knee every day for two years or to go bare-legged. All patients also received blood thinners.
About 25 percent of the participants who wore the stockings developed post-thrombotic syndrome within two years compared with 49 percent of those who did not wear stockings. The stockings did not decrease repeat episodes of DVT, which remained at 13 percent to 14 percent in both groups.
Early on, lifestyle changes such as frequent leg elevation and avoiding standing or sitting for long periods of time may be enough, Ginsberg wrote.
An alternative to stockings is the wait-and-see approach, where no action is taken until the patient develops symptoms, but the researchers don't know if compression stockings would work at that point. Ginsberg is starting a study to answer that very question.
"I think for now, until further evidence comes along, this is reasonable evidence to routinely apply stockings to patients," Ginsberg said.
"But I don't think we have enough evidence to force it on them if they don't feel there are benefits," he added.
Visit the National Heart, Lung, and Blood Institute for more on deep vein thrombosis.