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After a blood clot in the leg (deep vein thrombosis), compression stockings do not reduce complications

Berntsen CF, Kristiansen A, Akl EA, et al. Compression Stockings for Preventing the Postthrombotic Syndrome in Patients with Deep Vein Thrombosis. Am J Med. 2016;129:447.e1–447.e20

Review question

In people with a recent blood clot in the leg, are elastic compression stockings effective for reducing complications and recurrence?

Background

In people who have had blood clots in the leg (deep vein thrombosis), postthrombotic syndrome is a common complication. It includes symptoms such as leg swelling, itching, pain, and cramps. If you have had a blood clot in the leg, your doctor may suggest you wear a compression stocking to reduce swelling. These stockings are made of special elastic fabric. They may also help reduce your risk of getting postthrombotic syndrome or another blood clot in the leg.

How the review was done

The researchers did a systematic review, searching for studies that were published up to January 2015.

They found 7 randomized controlled trials with 1,581 people (average age 46 to 64 years, 43% to 60% men).

The key features of the studies were:

  • people had a previous blood clot in the leg that caused symptoms;
  • the blood clot was confirmed with imaging such as ultrasound;
  • people were treated with compression stockings starting 2 days to 1 year after the blood clot;
  • compression stockings were compared with no treatment or stockings that didn’t include compression; and
  • people were followed up for 2 to 7 years.

What the researchers found

Rates of complications, clot recurrence, death, and pain were similar in patients who used compression stockings and those who did not.

Conclusion

After a blood clot in the leg, elastic compression stockings do not reduce complications or prevent recurrence.

Compression stockings vs no compression stockings after a blood clot in the leg

Outcomes

Number of trials and people

Rate of events with compression stockings

Rate of events without compression stockings

Absolute effect of compression stockings

Postthrombotic syndrome*

5 trials (1,418 people)

Not reported

Not reported

No difference in effect at 2 to 7 years

Recurrence of blood clot in the leg

5 trials (1,283 people)

11%

13%

No difference in effect† at 2 to 7 years

Death

5 trials (1,214 people)

11%

11%

No difference in effect at 2 to 7 years

Pain

1 trial (806 people)

Not reported

Not reported

No difference in effect at 2 months

*A common complication after a blood clot in the leg. Symptoms include swelling, itching, pain, and cramps.

†Although the rates for the 2 groups look a little different, the differences were not statistically significant. This means that the differences could simply be due to chance rather than due to the different treatments.



Related Topics


Glossary

Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Web Resources

  • Preventing deep vein thrombosis

    Evidently Cochrane
    Compression stockings help to prevent deep vein thrombosis (blood clots and swelling) after surgery. You can choose to wear thigh or knee length stockings.
  • Stroke Prevention: Should I Have a Carotid Artery Procedure?

    OHRI
    This patient decision aid helps people who have had a mild (or moderate) stroke or one or more TIAs in the past 6 months and narrowing in your carotid artery decide on whether or not to have a carotid artery procedure by comparing the benefits, risks, and side effects of both options.
  • Varicose Veins: Should I Have a Surgical Procedure?

    OHRI
    This patient decision aid helps people with varicose veins decide on whether or not to have a surgical procedure by comparing the benefits, risks, and side effects of both options. It also includes alternative options like home care.
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