Skip the compression stockings following DVT
Although commonly used, compression stockings do not effectively prevent post-thrombotic syndrome.
There are currently no guidelines or consensus statements for or against the use of ECS after DVT.
CAVEATS: High nonadherence rates might have affected the results
In both groups, adherence to the assigned intervention diminished throughout the study. Overall, approximately 95% of patients reported wearing their stockings at one month; this dropped to just under 70% by 2 years. Theoretically, this could have affected efficacy outcomes. However, the decrease was similar in both groups and represents what is observed in clinical practice. A prespecified per protocol analysis of patients who wore their ECS more regularly found no benefit.
It is possible that a “placebo effect” could explain the lack of difference between groups. However, the placebo stockings provided virtually no compression, and the 2-year cumulative incidence of PTS in both the treatment and placebo groups was similar to that seen in control groups in prior studies.6,7
Finally, the incidence of PTS in this study was much lower than the 25% to 50% incidence reported in previous studies. Kahn et al1 suggested that this was because they used more stringent and standardized criteria for PTS than was used in previous research.
CHALLENGES TO IMPLEMENTATION: There are no barriers to ending this practice
We see no challenges to implementation of this recommendation.
Acknowledgement
The PURLs Surveillance System was supported in part by Grant Number UL1RR024999 from the National Center For Research Resources, a Clinical Translational Science Award to the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center For Research Resources or the National Institutes of Health.
