SCIENTIFIC EVIDENCE OF COMPRESSION TREATMENT

The following the result of two scientific studies that shows the effects of compression tratment on the chronic vascular disease are summarized.

*This consensus study as the editor Hugo Partsch1 is the result of an international expert meeting organized by the International Union of Phlebology (IUP) in August 2003 (Table 1). Recommended levels of compression in the treatment of A, B and C is rated at three levels. The higher statistical significant level, large randomize control trials’ and metaanalyses with homogenous results were assigned to a recommendation level A, the higher statistical significant level, smaller or the higher statistical significant level, single randomize control trials’ to a level B and observational studies or the opinion of the experts were taken as level C.

The following table summarizes the clinical indications and for compression class (A, I, II, III) according to the European CEN regulation the levels of recommendation for stockings. Chronic venous disorders are differentiated following the CEAP classification: C0 no visible varices, C1 teleangictasias, C2 large varicose veins, C3 oedema, C4 skin changes,

C5 ulcer scar, C6 venous ulcer.

Table 1. Scientific Evidence Of Compression Treatment, Hugo Partsch (2003)

Indications

Ccl A

Ccl I

Ccl II

Ccl III

C0, C1 symptomatic

B

B

C1

B

B

C2 asymptomatic

C

C2 symptomatic

C

C2 pregnancy

B

B

C2 After surgery

C

C

C

C2 After scleroteraphy

C

B-C

C3

B

C4b (LDS)

B

C5

B

B

B

C6

B

DVT prevention

A-B

A-B

Flights

B

B

DVT therapy

B

B

PTS prevention

B

B

A

Lymphoedema

C

C

DVT= Deep Vein Thrombosis, PTS= Postthrombotic Syndrome

** Marcondes Figuieredo2, summarized the scientific evidence in the meeting of International Compression Club in Paris in November 2007 (Table 2).

Table 2- Scientific Evidence Of Compression Treatment, Marcondes Figueiredo (2009)

Indications

Compression (mm Hg)

10-20

20-30

30-40

C0 s

1B

C1 s

1B

C1 s post-sclerotherapy

1B

C2 a, s

1B

2B

C2 s pregnancy

1B

1B

C3 prevention

1B

C3 therapy

2B

C4 B

1B

1B

C5

2B

1A

C6

1B

VTE Prevention

1A

VTE Therapy

1B

PTS Prevention

1A

PTS Therapy

2B

Lymphoedema Therapy

1B

a=asymptomatic; s=symptomatic; PTS=post-thrombotic syndrome; VTE=venous thromboembolism


 


1  H. Partsch, “Evidence Based Compression Therapy” Journal of Vascular Diseases, Volume 32, Supplement 63, December 2003.

2 Marcondes Figueiredo, “Scientific Evidence of Compression Treatment”, Journal of Vascular Brasileiro”, Volume 8, No:2.