Compression Therapy in Acute Deep Venous Thrombosis of the Lower Limb and for the Prevention of Post-Thrombotic Syndrome—a Review Based on a Structured Literature Search
After an acute deep venous thrombosis (DVT) of the lower limb, 20% to 63% of patients develop post-thrombotic syndrome (PTS). In this review, we address the efficacy of compression therapy in the treatment of acute DVT of the lower limb, and for the prevention of PTS. 12 randomized controlled trials...
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| Veröffentlicht in: | Deutsches Ärzteblatt international 2024-03, Vol.121 (6), p.188-194 |
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| creator | Thieme, Dorothea Linnemann, Birgit Mühlberg, Katja Noppeney, Thomas Kreutz, Maria Thieme, Marcus |
| description | After an acute deep venous thrombosis (DVT) of the lower limb, 20% to 63% of patients develop post-thrombotic syndrome (PTS). In this review, we address the efficacy of compression therapy in the treatment of acute DVT of the lower limb, and for the prevention of PTS.
12 randomized controlled trials (RCTs) and one meta-analysis, with a total of 3751 patients, were identified in a structured literature search.
Two RCTs showed that adding compression therapy to drug treatment in the first 9 days of the acute phase of lower limb DVT led to more rapid pain relief (p |
| doi_str_mv | 10.3238/arztebl.m2024.0001 |
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12 randomized controlled trials (RCTs) and one meta-analysis, with a total of 3751 patients, were identified in a structured literature search.
Two RCTs showed that adding compression therapy to drug treatment in the first 9 days of the acute phase of lower limb DVT led to more rapid pain relief (p<0.050) and less swelling (remaining difference in circumference, 1 cm versus 3 cm, p<0.050). As for the prevention of PTS, four RCTs showed a short-term benefit or no benefit of compression therapy. In three further RCTs, medical compression stockings (MCS) brought about a 16% to 27% absolute reduction of the frequency and severity of PTS (47% vs. 20 %, p<0.001; 40% vs. 21% (95% confidence intervals [29.9; 50.1] and [12.7; 29.5], respectively; and 58% vs. 42%, relative risk [RR] 0.73 [0,55; 0.96]). The benefit of MCS was also confirmed in a recent meta-analysis (RR 0.66 [0.44; 0.99], I2 = 88%). Thigh-length MCS were not superior to knee-length MCS for the prevention of PTS (33% vs. 36%, hazard ratio [HR] 0.93 [0.62; 1.41]). Individual, symptomoriented tailoring of the duration of treatment was not inferior to a fixed treatment duration of 24 months (29% vs. 28%; odds ratio [OR] 1.06 [0.78;1.44]).
Compression therapy relieves symptoms in acute DVT and lessens the frequency and severity of PTS. It is therefore recommended as standard treatment.</description><identifier>ISSN: 1866-0452</identifier><identifier>EISSN: 1866-0452</identifier><identifier>DOI: 10.3238/arztebl.m2024.0001</identifier><identifier>PMID: 38260965</identifier><language>eng</language><publisher>Germany: Deutscher Arzte Verlag</publisher><subject>Acute Disease ; Evidence-Based Medicine ; Female ; Humans ; Lower Extremity - blood supply ; Male ; Postthrombotic Syndrome - etiology ; Postthrombotic Syndrome - prevention & control ; Postthrombotic Syndrome - therapy ; Prevalence ; Randomized Controlled Trials as Topic ; Review ; Risk Factors ; Stockings, Compression ; Treatment Outcome ; Venous Thrombosis - complications ; Venous Thrombosis - prevention & control ; Venous Thrombosis - therapy</subject><ispartof>Deutsches Ärzteblatt international, 2024-03, Vol.121 (6), p.188-194</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c354t-227f6b2cc8c23e500773905a81acc0439153c0723d8febefe70f81abccbfd7153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079798/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079798/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38260965$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thieme, Dorothea</creatorcontrib><creatorcontrib>Linnemann, Birgit</creatorcontrib><creatorcontrib>Mühlberg, Katja</creatorcontrib><creatorcontrib>Noppeney, Thomas</creatorcontrib><creatorcontrib>Kreutz, Maria</creatorcontrib><creatorcontrib>Thieme, Marcus</creatorcontrib><title>Compression Therapy in Acute Deep Venous Thrombosis of the Lower Limb and for the Prevention of Post-Thrombotic Syndrome—a Review Based on a Structured Literature Search</title><title>Deutsches Ärzteblatt international</title><addtitle>Dtsch Arztebl Int</addtitle><description>After an acute deep venous thrombosis (DVT) of the lower limb, 20% to 63% of patients develop post-thrombotic syndrome (PTS). In this review, we address the efficacy of compression therapy in the treatment of acute DVT of the lower limb, and for the prevention of PTS.
12 randomized controlled trials (RCTs) and one meta-analysis, with a total of 3751 patients, were identified in a structured literature search.
Two RCTs showed that adding compression therapy to drug treatment in the first 9 days of the acute phase of lower limb DVT led to more rapid pain relief (p<0.050) and less swelling (remaining difference in circumference, 1 cm versus 3 cm, p<0.050). As for the prevention of PTS, four RCTs showed a short-term benefit or no benefit of compression therapy. In three further RCTs, medical compression stockings (MCS) brought about a 16% to 27% absolute reduction of the frequency and severity of PTS (47% vs. 20 %, p<0.001; 40% vs. 21% (95% confidence intervals [29.9; 50.1] and [12.7; 29.5], respectively; and 58% vs. 42%, relative risk [RR] 0.73 [0,55; 0.96]). The benefit of MCS was also confirmed in a recent meta-analysis (RR 0.66 [0.44; 0.99], I2 = 88%). Thigh-length MCS were not superior to knee-length MCS for the prevention of PTS (33% vs. 36%, hazard ratio [HR] 0.93 [0.62; 1.41]). Individual, symptomoriented tailoring of the duration of treatment was not inferior to a fixed treatment duration of 24 months (29% vs. 28%; odds ratio [OR] 1.06 [0.78;1.44]).
Compression therapy relieves symptoms in acute DVT and lessens the frequency and severity of PTS. It is therefore recommended as standard treatment.</description><subject>Acute Disease</subject><subject>Evidence-Based Medicine</subject><subject>Female</subject><subject>Humans</subject><subject>Lower Extremity - blood supply</subject><subject>Male</subject><subject>Postthrombotic Syndrome - etiology</subject><subject>Postthrombotic Syndrome - prevention & control</subject><subject>Postthrombotic Syndrome - therapy</subject><subject>Prevalence</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Review</subject><subject>Risk Factors</subject><subject>Stockings, Compression</subject><subject>Treatment Outcome</subject><subject>Venous Thrombosis - complications</subject><subject>Venous Thrombosis - prevention & control</subject><subject>Venous Thrombosis - therapy</subject><issn>1866-0452</issn><issn>1866-0452</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUU1O3DAUtlAroJQLsKi87CZT_0ziZFXRaWmRIhV1aLeW4zx3XCVxajuDhlUP0VtwK06CBwYEK7_n7-c9-0PohJIZZ7z8oPx1hKab9Yyw-YwQQvfQIS2LIiPznL16Vh-gNyH8IaSgFeP76ICXrCBVkR-im4XrRw8hWDfgyxV4NW6wHfCpniLgzwAj_gWDm0ICvesbF2zAzuC4Aly7K_C4tn2D1dBi4_z99YWHNQxxa5iIFy7EbKeNVuPlZmhTA7f__iv8A9YWrvAnFaDFia_wMvpJx8mnvrYxrbOt8RKU16u36LVRXYDj3XmEfp59uVx8y-rvX88Xp3WmeT6PGWPCFA3TutSMQ06IELwiuSqp0prMeUVzrolgvC0NNGBAEJOwRuvGtCKBR-jjg-84NT20Oj3Gq06O3vbKb6RTVr5EBruSv91aUkpEJaoyObzfOXj3d4IQZW-Dhq5TA6S_lKyioiw4y4tEZQ9U7V0IHszTHErkNma5i1nexyy3MSfRu-cbPkkec-V3SqWrTg</recordid><startdate>20240322</startdate><enddate>20240322</enddate><creator>Thieme, Dorothea</creator><creator>Linnemann, Birgit</creator><creator>Mühlberg, Katja</creator><creator>Noppeney, Thomas</creator><creator>Kreutz, Maria</creator><creator>Thieme, Marcus</creator><general>Deutscher Arzte Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240322</creationdate><title>Compression Therapy in Acute Deep Venous Thrombosis of the Lower Limb and for the Prevention of Post-Thrombotic Syndrome—a Review Based on a Structured Literature Search</title><author>Thieme, Dorothea ; Linnemann, Birgit ; Mühlberg, Katja ; Noppeney, Thomas ; Kreutz, Maria ; Thieme, Marcus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-227f6b2cc8c23e500773905a81acc0439153c0723d8febefe70f81abccbfd7153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acute Disease</topic><topic>Evidence-Based Medicine</topic><topic>Female</topic><topic>Humans</topic><topic>Lower Extremity - blood supply</topic><topic>Male</topic><topic>Postthrombotic Syndrome - etiology</topic><topic>Postthrombotic Syndrome - prevention & control</topic><topic>Postthrombotic Syndrome - therapy</topic><topic>Prevalence</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Review</topic><topic>Risk Factors</topic><topic>Stockings, Compression</topic><topic>Treatment Outcome</topic><topic>Venous Thrombosis - complications</topic><topic>Venous Thrombosis - prevention & control</topic><topic>Venous Thrombosis - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thieme, Dorothea</creatorcontrib><creatorcontrib>Linnemann, Birgit</creatorcontrib><creatorcontrib>Mühlberg, Katja</creatorcontrib><creatorcontrib>Noppeney, Thomas</creatorcontrib><creatorcontrib>Kreutz, Maria</creatorcontrib><creatorcontrib>Thieme, Marcus</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Deutsches Ärzteblatt international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thieme, Dorothea</au><au>Linnemann, Birgit</au><au>Mühlberg, Katja</au><au>Noppeney, Thomas</au><au>Kreutz, Maria</au><au>Thieme, Marcus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Compression Therapy in Acute Deep Venous Thrombosis of the Lower Limb and for the Prevention of Post-Thrombotic Syndrome—a Review Based on a Structured Literature Search</atitle><jtitle>Deutsches Ärzteblatt international</jtitle><addtitle>Dtsch Arztebl Int</addtitle><date>2024-03-22</date><risdate>2024</risdate><volume>121</volume><issue>6</issue><spage>188</spage><epage>194</epage><pages>188-194</pages><issn>1866-0452</issn><eissn>1866-0452</eissn><abstract>After an acute deep venous thrombosis (DVT) of the lower limb, 20% to 63% of patients develop post-thrombotic syndrome (PTS). In this review, we address the efficacy of compression therapy in the treatment of acute DVT of the lower limb, and for the prevention of PTS.
12 randomized controlled trials (RCTs) and one meta-analysis, with a total of 3751 patients, were identified in a structured literature search.
Two RCTs showed that adding compression therapy to drug treatment in the first 9 days of the acute phase of lower limb DVT led to more rapid pain relief (p<0.050) and less swelling (remaining difference in circumference, 1 cm versus 3 cm, p<0.050). As for the prevention of PTS, four RCTs showed a short-term benefit or no benefit of compression therapy. In three further RCTs, medical compression stockings (MCS) brought about a 16% to 27% absolute reduction of the frequency and severity of PTS (47% vs. 20 %, p<0.001; 40% vs. 21% (95% confidence intervals [29.9; 50.1] and [12.7; 29.5], respectively; and 58% vs. 42%, relative risk [RR] 0.73 [0,55; 0.96]). The benefit of MCS was also confirmed in a recent meta-analysis (RR 0.66 [0.44; 0.99], I2 = 88%). Thigh-length MCS were not superior to knee-length MCS for the prevention of PTS (33% vs. 36%, hazard ratio [HR] 0.93 [0.62; 1.41]). Individual, symptomoriented tailoring of the duration of treatment was not inferior to a fixed treatment duration of 24 months (29% vs. 28%; odds ratio [OR] 1.06 [0.78;1.44]).
Compression therapy relieves symptoms in acute DVT and lessens the frequency and severity of PTS. It is therefore recommended as standard treatment.</abstract><cop>Germany</cop><pub>Deutscher Arzte Verlag</pub><pmid>38260965</pmid><doi>10.3238/arztebl.m2024.0001</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Deutsches Ärzteblatt international, 2024-03, Vol.121 (6), p.188-194 |
| issn | 1866-0452 1866-0452 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Acute Disease Evidence-Based Medicine Female Humans Lower Extremity - blood supply Male Postthrombotic Syndrome - etiology Postthrombotic Syndrome - prevention & control Postthrombotic Syndrome - therapy Prevalence Randomized Controlled Trials as Topic Review Risk Factors Stockings, Compression Treatment Outcome Venous Thrombosis - complications Venous Thrombosis - prevention & control Venous Thrombosis - therapy |
| title | Compression Therapy in Acute Deep Venous Thrombosis of the Lower Limb and for the Prevention of Post-Thrombotic Syndrome—a Review Based on a Structured Literature Search |
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