The Effect of Compliance with Elastic Compression Stockings on Severity of Postthrombotic Syndrome after 2 Years in Patients Who Underwent Pharmacomechanical Catheter-Directed Thrombolysis for Acute Iliofemoral Deep Vein Thrombosis.

BACKGROUND: Deep vein thrombosis (DVT) poses significant risks, particularly postthrombotic syndrome (PTS). This study investigates the role of elastic compression stockings (ECS) in preventing PTS, focusing on patient adherence and its impact on therapeutic outcomes following pharmacomechanical catheter-directed thrombolysis (PMCDT) for acute iliofemoral DVT.

METHODS: This study evaluated 230 patients post-PMCDT for acute iliofemoral DVT, comparing 74 compliant and 156 noncompliant patients regarding PTS incidence and severity using Villalta and Venous Clinical Severity Score scores. Follow-ups included both clinical assessments and D-dimer measurements, along with evaluation of adherence to ECSs.

RESULTS: The compliant group (74 patients) showed a higher proportion of females (48.7%) compared to the noncompliant group (31.0%, P = 0.0435). Hospital stays were longer for compliant patients (3.91 days) than noncompliant patients (3.28 days, P = 0.002). At the 6-month follow-up, the rate of severe PTS was 4.05% in the compliant group and 7.05% in the noncompliant group (odds ratio [OR] = 0.56; 95% confidence interval [CI]: 0.15-2.06; P = 0.05). At 24 months, severe PTS was observed in 4.05% versus 8.97% (OR = 0.43; 95% CI: 0.12-1.54; P = 0.05). D-dimer levels were significantly lower in the compliant group at 6 months (1,103 ng/mL vs. 1,945 ng/mL, P < 0.001), but not at 24 months.

CONCLUSION: This study highlights the importance of patient adherence to ECS in reducing long-term complications following DVT treatment. Enhanced compliance strategies, including education and monitoring, are essential for improving recovery. Further research is necessary to optimize ECS use and prevent PTS.