Routine Stocking Therapy after Deep Venous Thrombosis: A Clinical Dilemma
Authors: Jeffrey S. Ginsberg
Journal: Annals of Internal Medicine (2004)

Editorials17 August 2004Routine Stocking Therapy after Deep Venous Thrombosis: A Clinical DilemmaJeffrey S. Ginsberg, MD, FRCPCJeffrey S. Ginsberg, MD, FRCPCFrom McMaster University, Hamilton, Ontario L8N 3Z5, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-4-200408170-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The post-thrombotic syndrome is one of the most common and frustrating chronic conditions that physicians encounter. Its clinical presentation varies from mild, painless edema of the leg to painful, incapacitating swelling of the affected limb with or without ulceration. Heit and colleagues (1) recently estimated that the post-thrombotic syndrome and venous ulcers have an annual health care cost of at least $200 million in the United States. Properly fitted graduated compression stockings, which exert pressure that is maximal in the distal calf and decreases in the more proximal part of the leg, have long been the cornerstone of management of ...References1. Heit JA, Rooke TW, Silverstein MD, Mohr DN, Lohse CM, Petterson TM, et al . Trends in the incidence of venous stasis syndrome and venous ulcer: a 25-year population-based study. J Vasc Surg. 2001;33:1022-7. [PMID: 11331844] CrossrefMedlineGoogle Scholar2. Lamping DL, Abenhaim LA, Kurz X, Schroter S, Kahn SR; the VEINES Group. Measuring quality of life and symptoms in chronic venous disorders of the leg: development and psychometric evaluation of the VEINES-QoL/VEINES-SYM questionnaire [Abstract]. Qual Life Res. 1998;7:621-2. Google Scholar3. Killewich LA, Bedford GR, Beach KW, Strandness DE. Spontaneous lysis of deep venous thrombi: rate and outcome. J Vasc Surg. 1989;9:89-97. [PMID: 2911146] CrossrefMedlineGoogle Scholar4. Saarinen J, Kallio T, Lehto M, Hiltunen S, Sisto T. The occurrence of the post-thrombotic changes after an acute deep venous thrombosis. A prospective two-year follow-up study. J Cardiovasc Surg Torino. 2000;41:441-6. [PMID: 10952338] MedlineGoogle Scholar5. van Haarst EP, Liasis N, van Ramshorst B, Moll FL. The development of valvular incompetence after deep vein thrombosis: a 7 year follow-up study with duplex scanning. Eur J Vasc Endovasc Surg. 1996;12:295-9. [PMID: 8896471] CrossrefMedlineGoogle Scholar6. Strandness DE, Langlois Y, Cramer M, Randlett A, Thiele BL. Long-term sequelae of acute venous thrombosis. JAMA. 1983;250:1289-92. [PMID: 6876315] CrossrefMedlineGoogle Scholar7. Markel A, Manzo RA, Bergelin RO, Strandness DE. Valvular reflux after deep vein thrombosis: incidence and time of occurrence. J Vasc Surg. 1992;15:377-82. [PMID: 1735898] CrossrefMedlineGoogle Scholar8. Prandoni P, Lensing AW, Prins MH, Frulla M, Marchiori A, Bernardi E, et al . Below-knee elastic compression stockings to prevent the post-thrombotic syndrome. A randomized, controlled trial. Ann Intern Med. 2004;141:249-56. LinkGoogle Scholar9. Villalta S, Bagatella P, Piccioli A, Lensing AWA, Prins MH, Prandoni P. Assessment of validity and reproducibility of a clinical scale for the post-thrombotic syndrome [Abstract]. Haemostasis. 1994;24 Suppl 1 157. Google Scholar10. Brandjes DP, Buller HR, Heijboer H, Huisman MV, de Rijk M, Jagt H, et al . Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet. 1997;349:759-62. [PMID: 9074574] CrossrefMedlineGoogle Scholar11. Ginsberg JS, Hirsh J, Julian J, Vander LaandeVries M, Magier D, MacKinnon B, et al . Prevention and treatment of postphlebitic syndrome: results of a 3-part study. Arch Intern Med. 2001;161:2105-9. [PMID: 11570939] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From McMaster University, Hamilton, Ontario L8N 3Z5, Canada.Grant Support: Dr. Ginsberg is a recipient of a Career Investigator Award from the Heart and Stroke Foundation of Ontario.Disclosures: None disclosed.Corresponding Author: Jeffrey S. Ginsberg, MD, FRCPC, Department of Medicine, McMaster University, McMaster University Medical Center, 1200 Main Street West, Room 3X28, Hamilton, Ontario L8N 3Z5, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBelow-Knee Elastic Compression Stockings To Prevent the Post-Thrombotic Syndrome Paolo Prandoni , Anthonie W.A. Lensing , Martin H. Prins , Michela Frulla , Antonio Marchiori , Enrico Bernardi , Daniela Tormene , Laura Mosena , Antonio Pagnan , and Antonio Girolami Metrics Cited byIncidence and cost burden of post-thrombotic syndromeEffect of prolonged treatment with compression stockings to prevent post-thrombotic sequelae: A randomized controlled trialEffectiveness of compression stockings to prevent the post-thrombotic syndrome (The SOX Trial and Bio-SOX biomarker substudy): a randomized controlled trialCompression with or without Early Ambulation in the Prevention of Post-thrombotic Syndrome: A Systematic Review 17 August 2004Volume 141, Issue 4Page: 314-315KeywordsAnklesDeep vein thrombosisEdemaInflammationQuestionnairesRandomized trialsSigns and symptomsStrokeThrombosisUlcers ePublished: 17 August 2004 Issue Published: 17 August 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...