Immediate Compression Helps Prevent DVT Complications

A new study suggests that immediate compression therapy following deep venous thrombosis (DVT) is associated with a reduction in residual vein occlusion (RVO).

Researchers at Maastricht University Medical Center (MUMC; The Netherlands), Flevoziekenhuis (Almere, The Netherlands), Nijmegen Medical Centre (UMCN; The Netherlands), and seven other Dutch academic and non-academic centers conducted a study involving 592 adult patients in order to examine if compression therapy immediately following a diagnosis of DVT affects the occurrence of RVO, and whether the presence of RVO is associated with post thrombotic syndrome and recurrent venous thromboembolism.

Study participants had an objectively confirmed proximal DVT of the leg, and received no compression within 24 hours of diagnosis. Compression therapy was then randomly administered using multilayered bandaging or compression hosiery (at a pressure of 35mmHg) until edema was reabsorbed, at which time all patients wore fitted compression stockings. All patients received anticoagulants in addition to compression therapy. Presence of RVO and recurrent venous thromboembolism were subsequently confirmed with compression ultrasonography and incidence of post thrombotic syndrome.

The results revealed that patients who received immediate compression therapy were 20% less likely to develop RVO, and eight percent less likely to suffer post thrombotic syndrome, compared to those who did not receive immediate compression; recurrent venous thrombosis showed no significant association with RVO. The researchers concluded that immediate compression should be offered to all patients with acute DVT of the leg, irrespective of severity of complaints. The study was published in the September 2018 issue of Blood.

“Although the use of compression stockings after DVT is routine across much of Europe, it is less common in the United States, where guidelines emphasize compression primarily for patients who complain of ongoing symptoms,” said senior study author Arina ten Cate-Hoek, MD, of Maastricht University. “Given these outcomes, and that compression stockings are fairly easy to self-administer, relatively inexpensive, and minimally intrusive, compression therapy offers a clear benefit for all patients with DVT.”

RVO, which occurs when clots persist in veins, is thought to be a contributing factor in the development of post thrombotic syndrome, a collection of persistent and often debilitating symptoms that can greatly diminish a person's quality of life, including pain, swelling, discoloration, and scaling in the affected leg.

Related Links:
Maastricht University Medical Center
Flevoziekenhuis
Nijmegen Medical Centre