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Elastic Compression Stockings for the Treatment of Post Thrombotic Syndrome - Buffalo Niagara Vein Expert at
Monday, August 12, 2013



Clinical recommendations have been made in the journal Chest regarding the use of elastic compression stockings.  Kealon and colleagues published an article in Chest in 2002 which stated that in patients with acute symptomatic deep vein thrombosis of the legs, the use of elastic compression stockings is recommended.  The authors concluded that compression stockings should be worn for two years after deep vein thrombosis and beyond that if the patient has developed post thrombotic syndrome. They reported relief of clinical symptoms with the use of elastic compression stockings in patients with post thrombotic syndrome.


The authors also show that patients who place a low value on preventing post thrombotic syndrome or high valve on avoiding the inconvenience and discomfort of stockings are likely to decline to wear compression stockings.


Another study looked at the value of wearing thigh high versus below knee elastic compression stockings for the prevention of post thrombotic syndrome.  This article is published in the journal Blood in 2001 by Prandoni and colleagues.  They evaluated 267 patients with first episode of proximal deep vein thrombosis and randomized them to either thigh length or below knee length elastic compression stockings use for two years.  The study showed that post thrombotic syndrome develops in 32.6% of patients who wore thigh length stockings versus 35.6% of patients who wore below knee compression stockings. 


Stockings related side effects have been quantitated in these groups of patients – they found premature discontinuation of stockings use in one in five (20%) patients wearing thigh high stockings versus and one in seven (13%) patients wearing below knee length elastic compression stockings.  The authors concluded that thigh length elastic compression stockings do not offer a better protection against post thrombotic syndrome than wearing below knee elastic compression stockings and are less well tolerated.


A reasonable clinical approach for wearing elastic compression stockings to prevent post hrombotic syndrome is that elastic compression stockings are unlikely to cause harm but are difficult to apply, uncomfortable to wear, expensive to use, and require replacement every several months.


Phlebologists or vein specialists should prescribe knee length (20 -30 mm Hg) compression stockings to patients with residual leg pain or swelling after deep vein thrombosis. Physicians should continue to prescribe and recommend patients to wear them as long as long as there is symptoms relief or if the patient is able to tolerate wearing them without additional discomfort.   


Contraindications to the use of medical grade elastic compression stockings are symptomatic claudication from peripheral arterial disease or allergy to the material contained in the compression stockings.


To get a free copy of Dr. Karamanoukian’s book called Post Thrombotic Syndrome contact him directly through his websie or call 716-839-3638 to get a free PDF copy.



 Post Thrombotic Syndrome and Deep Vein Thrombosis



For treatment and evaluation of post thrombotic syndrome in the Buffalo Niagara region and Southern Ontario contact Hratch Karamanoukian, MD FACS at the Vein Treatment Center with offices in Williamsville, New York and Clarence, New York or go to, or call 716-839-3638. and are partners with







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