DVT treatment with compression stockings to prevent post-phlebitic syndrome
A living, rapid review
Clinical summary: This meta-analysis suggests that high pressure compression stockings (> 30 mm Hg) worn for 2 years starting at the time of the deep vein thrombosis may be effective if more than 75% of patients are compliant at least 80% of the time. Similarly, the OCTAVIA trial isolates that benefit occurs from the second year of stockings. While the evidence is low quality using the GRADE assessment, the low cost and low adverse effects of the intervention suggest that stockings should be offered to patients at the time of acute thrombosis.
Methods overview: This repository is an openMetaAnalysis that updates previously published meta-analyses.(1,2) Newer studies included are listed in the references below. Rationale for newer trials excluded may be listed at the end of the references.
- Methods for openMetaAnalysis
- We included trials from the prior reviews if stockings were started within 4 weeks.
Results: Details of the studies included are in the:
- Reconciliation of studies included compared to stuides included in prior meta-analyses
- Description of studies (PICO table)
- Risk of bias assessment
- Source data for forest plots
The forest plot for the primary outcome is below. Additional forest plots of secondary analyses may be available.
Recent review(s) at time of last revision of this repository
- 1: Appelen D, van Loo E, Prins MH, Neumann MH, Kolbach DN. Compression therapy for prevention of post-thrombotic syndrome. Cochrane Database Syst Rev. 2017 Sep 26;9:CD004174. doi: 10.1002/14651858.CD004174.pub3. PMID: 28950030.
- Berntsen CF, Kristiansen A, Akl EA, Sandset PM, Jacobsen EM, Guyatt G, Vandvik PO. Compression Stockings for Preventing the Postthrombotic Syndrome in Patients with Deep Vein Thrombosis. Am J Med. 2016 Apr;129(4):447.e1-447.e20. doi: 110.1016/j.amjmed.2015.11.03. PMID: 26747198
- Tie HT, Luo MZ, Luo MJ, Li K, Li Q, Wu QC. Compression Therapy in the Prevention of Postthrombotic Syndrome: A Systematic Review and Meta-Analysis. Medicine (Baltimore). 2015 Aug;94(31):e1318. doi: 10.1097/MD.0000000000001318. PMID: 26252318; PMCID: PMC4616586
Randomized controlled trials
New trial(s) not included in the most recent review above
- Mol GC, van de Ree MA, Klok FA, Tegelberg MJ, Sanders FB, Koppen S, et al. One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial. BMJ. 2016 May 31;353:i2691. doi: 10.1136/bmj.i2691. PMID: 27245485
Trials undergoing assessment
Trial(s) included in the review(s) above
- Brandjes DP, Büller HR, Heijboer H, Huisman MV, de Rijk M, Jagt H, ten Cate JW. Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet. 1997 Mar 15;349(9054):759-62. PMID: 9074574
- Prandoni P, Lensing AW, Prins MH, Frulla M, Marchiori A, Bernardi E, Tet al. Below-knee elastic compression stockings to prevent the post-thrombotic syndrome: a randomized, controlled trial. Ann Intern Med. 2004 Aug 17;141(4):249-56. PMID: 15313740
- Kahn SR, Shapiro S, Wells PS, Rodger MA, Kovacs MJ, Anderson DR, et al; SOX trial investigators. Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial. Lancet. 2014 Mar 8;383(9920):880-8. doi: 10.1016/S0140-6736(13)61902-9. PMID: 24315521
- Jayaraj A, Meissner M. Impact of graduated compression stockings on the prevention of post-thrombotic syndrome - results of a randomized controlled trial. Phlebology. 2015 Sep;30(8):541-8. doi: 10.1177/0268355514544781. PMID: 25059736
This repository is cited by
- WikiDoc contributors. Deep vein thrombosis compression stockings. WikiDoc. July 2, 2016. Available at: http://www.wikidoc.org/index.php/Deep_vein_thrombosis_compression_stockings. Accessed July 2, 2016.
- Badgett RG, Rahal A. Comment on One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial. BMJ 2016 Available at https://www.bmj.com/content/353/bmj.i2691/rr