Thigh-length versus below-knee compression elastic stockings for prevention of the post-thrombotic syndrome in patients with proximal-venous thrombosis: a randomized trial.
Blood. 2011 Dec 16;
Authors: Prandoni P, Noventa F, Quintavalla R, Bova C, Cosmi B, Siragusa S, Bucherini E, Astorri F, Cuppini S, Dalla Valle F, Lensing AW, Prins MH, Villalta S
Abstract
Although below-knee compression elastic stockings (CES) are effective for prevention of the post-thrombotic syndrome (PTS), a substantial proportion of patients with deep venous thrombosis (DVT) still develop the PTS. In an open-label, randomized clinical trial, we compared thigh-length with below-knee CES for prevention of the PTS. 267 patients with the first episode of proximal DVT were randomized to wear either thigh-length or below-knee CES for 2 years. After 3, 6, 12, 18, 24 and 36 months, they were assessed for PTS manifestations according to the Villalta scale. PTS developed in 44 (32.6%) of the 135 patients randomized to thigh-length CES, and in 47 (35.6%) of the 132 allocated to below-knee CES, for an adjusted hazard ratio of 0.93 (95% CI, 0.62 to 1.41). Severe PTS developed in 3 patients in each group. Stockings-related side-effects developed in 55 (40.7%) of the 135 patients allocated to thigh-length CES, and in 36 (27.3%) of those randomized to the below-knee group (p=0.017), and led to premature discontinuation of their use in 29 (21.5%) and 18 (13.6%) patients, respectively. We conclude that thigh-length CES do not offer a better protection against PTS than below-knee CES and are less well tolerated (Clinical Trial number: NCT00426075).
PMID: 22180438 [PubMed - as supplied by publisher]