Compression for the prevention of post-thrombotic syndrome after deep vein thrombosis: What is the ideal therapy duration?

This One-Pager discusses the prevention of post-thrombotic syndrome following deep vein thrombosis. It reviews whether stopping elastic compression therapy after 12 months is non-inferior to continuing it for an additional 12 months. This One-Pager is published in English, German, French, Italian, Polish and Russian.

Compression for the prevention  of post-thrombotic syndrome after deep vein thrombosis: What is the ideal therapy duration?

Current consensus

Elastic compression stockings (ECS) are recommended in the prevention of post-thrombotic syndrome (PTS) following deep vein thrombosis (DVT).

Problem

The optimal therapy duration still remains undefined.

OCTAVIA study

The OCTAVIA study (1) was designed to assess whether stopping ECS therapy after 12 months is non-inferior to continuing it for an additional 12 months.

Participants

  • n = 518

PTS-free and compliant with ECS therapy (34-46mmHg) for 12 months subsequent to DVT diagnosis.

Patient randomization

The patients were divided in two groups after DVT diagnosis:

Group 1: Stop-ECS = Stop after inital 12 months

  • n = 260
  • 4 ineligible (excluded)
  • Assessed: n = 256
  • Lost to follow-up: n = 6
  • Withdrew: n = 13
  • Died: n = 2

Group 2: Continue-ECS = Continue for +12 months

  • n = 262
  • 0 ineligible
  • Assessed: n = 262
  • Lost to follow-up: n = 6
  • Withdrew: n = 6
  • Died: n = 0

Results

Primary Outcome = PTS incidence 24 months after DVT diagnosis

In group 1 (stop-ECS), 51 patients got sick from post thrombotic syndrome, while in group 2 (continue-ECS) it were 34 patients. The risk for PTS in the stop-ECS group is 60% higher compared to the continue-ECS group.

To prevent one case of PTS by continuing ECS therapy for 24 months, the number of patients needed to treat is 14. 

The continue-ECS group showed a high compliance rate, as 85% of this group wore the ECS for 6-7 days per week.

Conclusion

Stopping ECS after 12 months in compliant patients with proximal DVT was not non-inferior than (≈ was "not as good as") continuing ECS therapy for an additional 12 months in preventing PTS.

Author's suggestion

Compression therapy should ideally be continued for 24 months after DVT.

Auch lesenswert

Compression therapy in veno-lymphatic disorders

Compression therapy in veno-lymphatic disorders

This One-Pager discusses different types of compression products in veno-lymphatic disorders. It focuses on characteristics of compression therapy types and on how to choose the best garment for an individual patient. This One-Pager is published in English, German, French, Italian, Polish and Spanish.
The effect of medical compression stockings and leg elevation on local inflammatory biomarkers in healthy subjects & CVI patients

The effect of medical compression stockings and leg elevation on local inflammatory biomarkers in healthy subjects & CVI patients

This One-Pager reviews the effects of medical compression stockings and leg elevation on local inflammation. It is available for download in English, German, French, Italian, Spanish, Portuguese and Polish.
Tiefe Venenthrombose (TVT)

Tiefe Venenthrombose (TVT)

TVT (tiefe Venenthrombose) ist eine ernste Erkrankung. Ein Blutgerinnsel bildet sich in den tiefen Venen des Unterschenkels oder der Wade und blockiert den Blutfluss . TVT kann zu Schwellungen, Rötungen und Schmerzen am Bein führen. Sie kann aber auch ohne diese Symptome auftreten. Eine TVT kann lebensbedrohlich werden, wenn sich das Blutgerinnsel von seiner ursprünglichen Position in der Vene löst und durch die Blutbahn in die Lunge gelangt. Dieses potenziell tödliche Ereignis ist als Lungenembolie (LE) bekannt. Hier finden Sie Informationen zur TVT und Lösungen zur Vorbeugung.
Diesen Artikel teilen
LinkedIn
Twitter
Facebook