Objective Evaluation of Compression Therapy for Deep Vein Thrombosis by Ambulatory Strain-Gauge Plethysmography

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Abstract
Objective: To evaluate objectively the effect of compression therapy in patients with different degrees of calf muscle pump impairment following deep vein thrombosis. Design: Prospective study. Setting: Second Department of Surgery, Tottori University School of Medicine, Yonago, Japan. Patients: Twenty-one lower extremities in 16 patients and 23 lower extremities in 13 healthy control subjects. Intervention: Application of standard compression elastic stockings (30–40 mmHg compression at the ankle) and high compression elastic stockings (40–50 mmHg at the ankle) (Sigvaris, Sweden). Main outcome measures: Comparison of expelled volume measured by ambulatory strain-gauge plethysmography. Results: Calf pump function after deep vein thrombosis was classified into three grades (normal, compensated and failed) by the expelled volume. The expelled volume increased from 0.4 ml/dl (SD 0.2) to 0.9 ml/dl (SD 0.5) following the application of strong compression. Conclusion: Compression therapy is haemodynamically effective only when using strong compression (40–50 mmHg) in patients with post-thrombotic syndrome.

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