title: Effects of elastic compression on hypomobility edema and fibrinolysis activation in multiple sclerosis.
abstract: OBJECTIVE
  In multiple sclerosis (MS) patients, loss of mobility leads to edema of the legs and raises their risk of thrombosis. They cannot use pharmacological prophylaxis over the long course of the disease. Elastic compression stockings are indicated to prevent venous thrombosis for hypomobile patients, and might therefore also limit edema. The aim of the study was to assess the feasibility of elastic compression with ATE stockings in severely disabled MS patients, and to make a preliminary assessment of their efficacy and safety.
  
  
  METHODS
  We checked 201 MS patients, in a rehabilitation unit, by ultrasound for residues of thrombosis and recorded the duration of the MS, residual autonomy, and leg edema. Ninety-nine patients served as controls, and 102 were prescribed antithromboembolic stockings, to be worn 24h/day.
  
  
  RESULTS
  The intervention group had higher baseline d-Dimer (471 ± 590 vs. 271 ± 183 mg/dL) and more had lower leg edema (80% vs. 40%). In all treated patients the edema disappeared. There were no cases of symptomatic deep venous thrombosis. D-Dimers dropped significantly in both groups, though more in the intervention group (to 363 ± 420 mg/dL, P=0.0001 and to 254 ± 180 mg/dL for controls, P=0.01).
  
  
  CONCLUSIONS
  Antithromboembolic stockings can help eliminate edema of the legs in MS patients, and may also reduce the thrombotic risk: the lower d-Dimer values suggest an effect on the activation of inflammation and coagulation resulting from stasis-induced endothelial damage.
authors: Vascular Medicine, Vimercate Hospital, Milan, Italy. guido.arpaia@tin.it
authors: G
authors: G
authors: Arpaia
authors: P M
authors: PM
authors: Bavera
authors: D
authors: D
authors: Caputo
authors: L
authors: L
authors: Mendozzi
authors: R
authors: R
authors: Cavarretta
authors: M
authors: M
authors: Rovaris
authors: G B
authors: GB
authors: Agus
authors: G
authors: G
authors: Belcaro
authors: M
authors: M
authors: Milani
authors: E
authors: E
authors: Ippolito
authors: G
authors: G
authors: Spezzigu
authors: C
authors: C
authors: Cimminiello
mesh_terms: D000368:Aged; D004487:Edema / Q000473:pathology / Q000628:therapy; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005342:Fibrinolysis; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000473:pathology / Q000628:therapy*; D053828:Stockings, Compression
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D