title: Thigh-length versus below-knee compression elastic stockings for prevention of the postthrombotic syndrome in patients with proximal-venous thrombosis: a randomized trial.
abstract: Although below-knee compression elastic stockings (CES) are effective for the prevention of the postthrombotic syndrome (PTS), a substantial number of patients with deep venous thrombosis still develop PTS. In the present open-label, randomized clinical trial, we compared thigh-length with below-knee CES for the prevention of PTS. A total of 267 patients with the first episode of proximal deep venous thrombosis 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% confidence interval, 0.62-1.41). Severe PTS developed in 3 patients in each group. CES-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 = .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.
authors.affiliation: Department of Cardiovascular and Thoracic Sciences, Clinica Medica 2, University of Padua, Via Giustiniani 2, Padua, Italy. paoloprandoni@tin.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Prandoni
authors.forename: Franco
authors.initials: F
authors.lastname: Noventa
authors.forename: Roberto
authors.initials: R
authors.lastname: Quintavalla
authors.forename: Carlo
authors.initials: C
authors.lastname: Bova
authors.forename: Benilde
authors.initials: B
authors.lastname: Cosmi
authors.forename: Sergio
authors.initials: S
authors.lastname: Siragusa
authors.forename: Eugenio
authors.initials: E
authors.lastname: Bucherini
authors.forename: Francesco
authors.initials: F
authors.lastname: Astorri
authors.forename: Stefano
authors.initials: S
authors.lastname: Cuppini
authors.forename: Fabio
authors.initials: F
authors.lastname: Dalla Valle
authors.forename: Anthonie W A
authors.initials: AW
authors.lastname: Lensing
authors.forename: Martin H
authors.initials: MH
authors.lastname: Prins
authors.forename: Sabina
authors.initials: S
authors.lastname: Villalta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004890:Erythema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007717:Knee; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D054070:Postthrombotic Syndrome / Q000209:etiology / Q000517:prevention & control*; D011537:Pruritus / Q000209:etiology; D053828:Stockings, Compression / Q000009:adverse effects / Q000145:classification / Q000592:standards*; D013848:Thigh; D013997:Time Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications*; D055815:Young Adult