Use of graduated compression stockings in acute DVT for prevention of post-thrombotic syndrome (PTS)

 

Initial studies from 1997-2004 suggested that stockings with 30-40 mmHg compression at the ankle can half the incidence of PTS. However, the randomised SOX Trial (Kahn, et al 2013) was much larger and blinded doctors and patients by comparing stockings with 30-40 mmHg pressure with placebo stockings giving negative results.

Stockings do not require to be prescribed routinely but only used selectively in patients to treat symptoms.

Absolute contra-indications are advanced peripheral arterial occlusive disease, decompensated heart failure, septic phlebitis, and phlegmasia caerulea dolens (DVT leading to severe swelling of the whole leg).

Relative contra-indications are suppurative dermatoses, intolerance of compression stocking fabric, advanced neuropathy, and chronic arthritis.