PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Stockings, Compression”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed1999

Prevalence of venous insufficiency in French adults of the SUVIMAX cohort. SUpplémentation en VItamines et Minéraux AntioXydants.

BACKGROUND: The symptoms of venous insufficiency of the lower limbs (VILL) include a feeling of heaviness in the legs, pain, and nocturnal cramps, which may be combined with organic disorders (varicose veins). The objective of this study was to determine the prevalence of VILL in terms of both varicose veins and functional symptoms in the participants of the SUVIMAX cohort, which is representative of the French population for the age range under consideration (women: 35-60; men: 45-60). METHODS: Information on the venous status of 3065 subjects in the SUVIMAX cohort were collected from three different sources: yearly systematic clinical examination (1994-1996), monthly follow-up by a telematic network (1994-1998) and non-specific questionnaire (1997). Two mutually exclusive populations were thus defined on medically diagnosed varicose veins and venous insufficiency and reported varicose veins and venous insufficiency. RESULTS: Venous insufficiency was medically diagnosed in 192 men (14.6%) and 584 women (33.6%), and varicose veins were diagnosed in 143 men (74.5%) and 317 women (54.2%) from this group. Prevalence reported symptoms of venous insufficiency and of varicose veins was 13.6% and 7.4% respectively in men and 28.2% and 12.4% in women. Sex, age, body mass index and number of pregnancies were found to be correlated with the risk of venous insufficiency. CONCLUSIONS: VILL is a very common disease in French adults both as varicose veins and as functional symptoms. Venotonics were the main type of treatment but not enough use is made of elastic compression stockings.

Adult↗
PubMed1999

[Deep vein thrombosis--diagnosis and therapy].

For diagnosis of deep vein thrombosis an objective visualising method is indispensable (Duplex sonography, phlebography, MRI). The approval of several preparations of low-molecular-weight heparin made therapy easy: subcutaneous injections of fixed doses which are mainly adjusted to body-weight allow safe and effective anticoagulation without the need of special laboratory testing. Mobile patients should be kept walking with compression of their legs. Secondary prophylaxis consists of oral anticoagulation or alternatively in low-molecular-weight heparin and compression stockings.

Anticoagulants↗
PubMed1999

[Venous thrombectomy in pregnancy. A follow-up study].

Deep venous thrombosis is an uncommon but feared complication in pregnancy. The treatment of choice in most centers is heparin and compression stockings, which effectively prevents pulmonary embolism, but the incidence of chronic venous insufficiency with skin change and ulcers after such treatment is reported to be up to 65%. In the period 1985-93, thirty-nine pregnant women were treated for femoroiliacal venous thrombosis (FIVT) with operative thrombectomy, arteriovenous fistula and anticoagulant therapy. The aim of this study was to examine those of the women who subsequently had been pregnant again. The pregnancy and delivery were closely monitored and the frequency of clinically detected as well as objectively measured venous insufficiency was recorded. Nineteen of the women subsequently became pregnant again, resulting in 25 deliveries. They were investigated at the Coagulation Laboratory and treated with phenendione or low molecularweight heparin. All pregnancies proceeded successfully. None showed clinical signs of rethrombosis during the subsequent pregnancy. At follow up 11 patients had dilated or varicose veins, nine had a closed iliaca at ultrasound examination, none had skin changes or ulcers. We conclude that women treated for FIVT in pregnancy with thrombectomy followed by anticoagulant therapy may undergo a new pregnancy with low risk of obstetrical complications and with a low risk of developing rethrombosis or chronic venous insufficiency.

Anticoagulants↗
PubMed1999

[Economy class syndrome: fiction or fact?].

Several reports about the occurrence of deep vein thrombosis and pulmonary embolism following long-distance flights have led to the term "economy class syndrome". The underlying hypothesis was that a long term immobilisation in narrow economy class chairs of modern jet aircraft plays an important role for the development of deep vein thrombosis. Studies in healthy volunteers during several simulated long distance flights and during an actual long-distance flight confirmed the swelling of the lower legs complained by many long distance passengers, however, failed to reveal relevant changes of hemorheological or hemostaseological parameters. From these investigations no increased risk for thromboembolic diseases during long distance flights for healthy volunteers could be derived. Since this may be completely different for patients with risk factors for thromboembolic diseases prophylactic measures (compression stockings, anticoagulation) might be necessary.

Aircraft↗
PubMed2000

New therapeutic options in DVT prophylaxis.

In the absence of prophylaxis, elective orthopedic surgery is associated with a high risk of venous thromboembolic events that are responsible for substantial morbidity and mortality. Despite the publication of articles questioning the significance of fatal pulmonary embolism (PE) following elective hip replacement, recent reports support the need for effective thromboprophylaxis in this indication. These reports also provide evidence of a significant reduction in fatal PE and overall mortality provided by treatment with low-molecular-weight heparin (LMWH), compared with unfractionated heparin. Even with the most effective prophylaxis currently available, however, deep vein thrombosis still develops in a minority of high-risk patients, indicating a need for improved therapies. Desirudin, a novel recombinant hirudin and direct thrombin inhibitor, has been shown to provide more effective prophylaxis than the most widely used LMWH, enoxaparin, in orthopedic surgery patients with multiple thromboembolic risk factors. This benefit was not associated with any increase in bleeding. Regional anesthesia and use of graduated compression stockings may provide additional independent reductions in thromboembolic risk in elective orthopedic surgery.

Anesthesia, Conduction↗
PubMed2000

[CBO guideline 'Deep venous thrombosis and pulmonary embolism; revision of the earlier guidelines. Dutch Organization for Quality Assurance in Hospitals].

Diagnosis of clinically suspected deep venous thrombosis is based on a clinical score, serial compression ultrasonography and D-dimer assay. For the diagnosis of pulmonary embolism perfusion scintigraphy, ventilation scintigraphy, echography of the leg veins and pulmonary angiography in that order lead to the lowest mortality, morbidity and costs. Diagnostics with spiral CT followed by pulmonary angiography leads to equal mortality and fewer angiography procedures. Decision rules based on anamnesis, physical examination, blood gas analysis and chest radiograph have proved to be insufficiently reliable. The present D-dimer assays have too little sensitivity and too much variability. Thrombo-prophylaxis with low-molecular-weight heparin is indicated for general surgery, joint replacement of the knee or hip, cranial and spinal surgery, subarachnoid haemorrhage after surgical treatment of an aneurysm, acute myocardial infarction, ischaemic stroke or spinal cord lesion, intensive care patients, patients with acute paralysis due to a neuromuscular disorder, and bedridden patients with a risk factor. Prophylaxis has to be continued as long as the indication exists. In the acute phase of deep venous thrombosis or pulmonary embolism treatment with (low-molecular-weight) heparin in an adequate dose is necessary. When started at the same time as coumarin derivatives the treatment with heparin has to be continued for at least 5 days. The risk of postthrombotic syndrome after deep venous thrombosis will be lowered by carrying compression stockings for at least 2 years after the event.

Anticoagulants↗
PubMed2001

[Acute thrombosis of pelvic and leg veins in agenesis of the renal segment of the inferior vena cava].

A 19-year-old, otherwise asymptomatic man presented to the hospital of orthopaedic surgery with acute severe pain like lumbago. Symptomatic treatment was performed after extensive orthopaedic diagnostic procedures. On the third day after admission he showed clinical signs of deep vein thrombosis with painful swelling and livid discoloration of both legs. Colour duplex ultrasound revealed complete thrombosis of the leg and pelvic veins bilaterally, but the cranial extent was not clear. Contrast-enhanced helical computer tomography of the abdomen and the pelvis confirmed deep pelvic vein thrombosis and showed extension into the inferior vena cava. Moreover, the study revealed the agenesis of the renal segment of the inferior vena cava with collateral flow through dilated lumbar veins to enlarged azygous and hemiazygous, through vertebral and paravertebral venous plexus. The renals were drained via dilated capsular veins. The agenesis of renal vena cava is a very rare anomaly causing acute thrombosis of the deep leg and pelvic veins. Other risk factors of thromboembolic disease were not found. The patient was treated successfully with systemic thrombolysis. Therefore we used ultra-high streptokinase infusion (9 million units over 6 hours). Colour duplex ultrasound revealed good flow into deep leg and pelvic veins after three cycle of lysis. Magnetic resonance angiography of the abdomen and pelvis was performed to evaluate the successful fibrinolysis with complete recanalisation of the pelvic veins and to demonstrate the venous anatomy. Permanent oral anticoagulation with phenprocoumon is indicated to decrease the high rate of recurrent thrombosis. Compression stockings were prescribed. To prevent thrombosis, additional risk factors like smoking, immobilization and unusual physical activity should be strictly avoided.

Acute Disease↗
PubMed2001

[Therapy of venous thromboembolism].

Deep venous thrombosis and lung embolism are often considered as two different variants of the same disease. This is evident not only in the same pathogenesis but also in a comparable prognosis and therapy. Therefore the term "venous thromboembolism" is used in recent literature. The main therapy of venous thromboembolism is anticoagulation and initially consists of (low molecular weight) heparin followed by a regimen with oral anticoagulants--the duration depending on the indication. Pharmacokinetic advantages of low molecular weight heparin (LMWH) allow weight-adapted dosing with daily subcutaneous injections in most patients. LMWH do not require any laboratory controls. Therefore outpatient treatment should be possible for about 75% of patients with venous thromboembolism. Outpatient treatment of lung embolism, however, is still being studied and therefore not recommended apart from clinical trials. In cases of massive venous thromboembolism additional treatment with thrombolytic agents or surgery is needed. Adequately fit compression stockings can reduce the risk of post-thrombotic syndrome after deep venous thrombosis. Patients on long-term oral anticoagulation may learn to measure their INR with a portable coagulation monitor and adjust the dosage of the anticoagulants themselves--this method is called patient self-management of oral anticoagulation.

Ambulatory Care↗
PubMed2001

Hemorrhoids and varicose veins: a review of treatment options.

Hemorrhoids and varicose veins are common conditions seen by general practitioners. Both conditions have several treatment modalities for the physician to choose from. Varicose veins are treated with mechanical compression stockings. There are several over-the-counter topical agents available for hemorrhoids. Conservative therapies for both conditions include diet, lifestyle changes, and hydrotherapy which require a high degree of patient compliance to be effective. When conservative hemorrhoid therapy is ineffective, many physicians may choose other non-surgical modalities: injection sclerotherapy, cryotherapy, manual dilation of the anus, infrared photocoagulation, bipolar diathermy, direct current electrocoagulation, or rubber band ligation. Injection sclerotherapy is the non-surgical treatment for primary varicose veins. Non-surgical modalities require physicians to be specially trained, own specialized equipment, and assume associated risks. If a non-surgical approach fails, the patient is often referred to a surgeon. The costly and uncomfortable nature of treatment options often lead a patient to postpone evaluation until aggressive intervention is necessary. Oral dietary supplementation is an attractive addition to the traditional treatment of hemorrhoids and varicose veins. The loss of vascular integrity is associated with the pathogenesis of both hemorrhoids and varicose veins. Several botanical extracts have been shown to improve microcirculation, capillary flow, and vascular tone, and to strengthen the connective tissue of the perivascular amorphous substrate. Oral supplementation with Aesculus hippocastanum, Ruscus aculeatus, Centella asiatica, Hamamelis virginiana, and bioflavonoids may prevent time-consuming, painful, and expensive complications of varicose veins and hemorrhoids.

Diagnosis, Differential↗
PubMed2001

Incidence, natural history and risk factors of deep vein thrombosis in elective knee arthroscopy.

AIMS: to determine the incidence, anatomical distribution and extent of deep vein thrombosis (DVT) in limbs undergoing elective unilateral knee arthroscopy without active prophylaxis, to evaluate its effect on venous function following early diagnosis, and to quantify the impact of risk factors on its incidence. METHODS: 102 consecutive patients undergoing unilateral knee arthroscopy without prophylaxis were studied. A history was obtained with emphasis on the risk factors for thromboembolism, and physical examination and colour duplex were performed prior to and within a week after surgery. Patients who developed calf DVT were given aspirin (150 mg) and compression stockings; those with proximal DVT were admitted for anticoagulation (heparin followed by warfarin). Follow-up (mean 118 [range 84-168] days) entailed weekly physical and duplex examinations during the first month and monthly thereafter. RESULTS: 8 patients developed calf DVT in the operated leg (incidence 7.84% [95% CI: 2.7%-13.2%]); thrombosis was asymptomatic in 4 of those (50%), caused calf tenderness in 4 (50%) and a positive Homan's sign in one (12.5%). DVT occurred in the following veins: peroneal 4 subjects (50%), soleal 4 (50%), gastrocnemial 2 (25%) and tibial 2 (25%). Propagation of a calf DVT to the popliteal vein was identified in 1 patient (12.5%). After a median period of 118 days, total clot lysis was found in 50% of DVTs. with partial thrombus resorption in the rest; reflux in the thrombosed veins was present in 75% of limbs with DVT. 43% of patients had 1 risk factor for DVT and 20% had > or = 2. The incidence of DVT was higher amongst those with two or more risk factors for thromboembolism (p <.05) or those with previous thrombosis alone (p <.005). Symptoms or signs of pulmonary embolism were not documented. CONCLUSIONS: Elective unilateral knee arthroscopy performed without prophylaxis is complicated by ipsilateral calf DVT in 7.8% (95% CI: 2.7%-13.2%) of cases. The risk is higher in the presence of previous thrombosis (relative risk: 8.2) and two or more risk factors for DVT (relative risk: 2.94). Thrombosis may propagate to the proximal veins, despite early diagnosis. 50% of calf clots totally lyse in 4 months, yet reflux develops in at least 75% of limbs with DVT. Further studies to determine optimal prophylaxis are warranted.

Adolescent↗
PubMed1999

Thromboembolism in laparoscopic surgery: risk factors and preventive measures.

The aim of this study was to assess the risk of clinical thromboembolism in laparoscopic digestive surgery. From June 1992 to June 1997, 2,384 consecutive patients were studied. All received perioperative prophylaxis with low-molecular-weight heparin (LMWH), which was continued until full mobility was regained. Eight cases (0.33%) of deep venous thrombosis were noted, but there were no cases of pulmonary embolus. In six cases (five cholecystectomies with reverse Trendelenburg position and one inguinal hernia repair), release of the pneumoperitoneum took longer than 2 hours, and in two cases (one rectopexy and one sigmoid colectomy for diverticulitis), longer than 3 hours. In six of the eight cases, the diagnosis of DVT was made after LMWH had been ceased and the patient had been discharged. All cases were diagnosed before the 10th postoperative day. Pneumoperitoneum is felt to predispose to deep venous thrombosis. Long operations and reverse Trendelenburg position are further potentiating factors. Thromboprophylaxis for laparoscopy should be the same as for conventional surgery, i.e., tailored to individual risk and continued for a minimum of 7 to 10 days. We also recommend using graduated compression stockings, maintaining a relatively low insufflation pressure, keeping use of the reverse Trendelenberg position to a minimum, and intermittently releasing the pneumoperitoneum in longer procedures.

Adolescent↗
PubMed2001

[Thromboembolism in travelers].

The association between long haul travel and the risk of venous thromboembolism are suspected for long time. Mostly air travel related thrombosis series have been reported in the literature. Risk factors can be classified as: 1. travel related factors (coach position, immobilization, prolonged air travel, narrow seat and room, diuretic effect of alcohol, insufficient fluid intake, dehydration, direct pressure on leg veins, rare inspiration). 2. air plane related risk factors (low humidity, relative hypoxia, stress). 3. patient related factors (hereditary and acquired thrombophylia, previous deep venous thrombosis, age over 40, recent surgery or trauma, gravidity, puerperium, oestrogen containing pills, varicosity, chronic heart disease, obesity, fever, diarrhoea, vomiting, smoking). No patient related factors were found in some cases. To reduce the hazards air travellers are rightly concerned to know the level of the risk and the airlines should be responsible for this information. People should discuss with their physician what prophlylactic measures should be taken, such as compression stockings or low molecular weight heparin. Not only flight but car, bus and train travellers are also at risk of developing venous thromboembolism. Long haul travel alone is a separate risk factor for venous thromboembolism.

Humans↗
PubMed2002

["Vein School." A program of education for chronic venous insufficiency patients at the La Léchère Hotspring].

Chronic venous insufficiency is a frequent and invalidating condition, which also represents an important socio-economical burden. As it is a chronic disease with no effective curative therapy, the preventive and educational means are of particular interest. The present health policy insists on the education given to patients suffering from chronic disease, but contrasting with other chronic conditions (diabetes, asthma, chronic back pain), to our knowledge, there is no published structured educational training programme dedicated to people suffering from CVI. Such an educational programme was developed at the spa resort of La Léchère (Savoie, France), which is specialized in the treatment of CVI. Proposed to voluntary patients taking the waters and driven by a multidisciplinary team (doctors, nurses, pharmacists), the objective was to promote a better knowledge in venous disease by the patients and to make them adopt a more active behaviour in their treatment. Three topics were approached in interactive work-groups using a problem solving teaching technique: "anatomy and physiology of the circulatory system", "venous diseases", "practical aspects life with compression stockings". Comparison of pre and post-teaching evaluations was performed in 149 unselected patients, allowing a short-term appraisal of the knowledge improvement. It showed a 25 to 40% increase in right answers according to the tested topic. Further evaluation of long term beneficial effects is needed. However, the high interest of patients regarding this teaching method and the content of the programme provides good expectations regarding a real beneficial effect on health and quality of life.

Attitude to Health↗
PubMed2002

[Traveler's thrombosis: incidence, etiology, prevention].

The number of persons traveling by airplane, railway or bus is on the increase. Recently, there has been a growing number of reports on travel-related disorders after long journeys, especially long-haul flights (i.e. deep venous thrombosis (DVT) and pulmonary thromboembolism (VTE), also known as "economy class syndrome" or "traveler's thrombosis"). The exact incidence of travel related thrombosis is not known. Contributing factors for DVT and VTE are sitting in a cramped position for hours, low humidity and lowered oxygen pressure in the aircraft cabin, reduced fluid intake and dehydration, as well as individual risk factors. In this review article definitions for risk groups (low, moderate and high risk for DVT and VTE) and recommendations for prevention (leg exercise, fluid intake, compression stockings and application of low molecular weight heparins) of travel related thrombosis, based on the outcome of a recent expert meeting, are presented.

Bandages↗
PubMed2002

Pharmaco-epidemiology of the treatment of chronic venous insufficiency in general medicine.

BACKGROUND: A report is presented of a multicenter pharmaco-epidemiological study on chronic venous insufficiency conducted in France on 5043 patients. METHODS: It was based on a questionnaire that included the demographic characteristics of the patients, their risk factors for venous disease, history of venous insufficiency, physical and functional symptoms, and clinical stage according to the CEAP classification, as well as modalities of treatment and professional practice of the participating doctors. The various treatment modalities (phlebotonics, compression stockings, sclerotherapy and surgery) were related to the stage of the venous insufficiency and to the satisfaction expressed by the patients. RESULTS: The results of the study showed a minimum annual sick leave rate of 7.2%. CONCLUSIONS: In conclusion, this study brings to the fore the change in treatment modalities for venous insufficiency according to its severity stage, principally as regards medico-economics.

Adult↗
PubMed2000

Thromboembolism prophylaxis and incidence of thromboembolic complications after laparoscopic surgery.

UNLABELLED: The aim of this prospective study was to assess the clinical thrombo-embolic risk in laparoscopic digestive surgery. METHODS: The study prospectively included 2384 patients, who underwent laparoscopic surgery between June 1992 and June 1997. All patients received peri-operative low molecular weight heparin (LMWH) thromboprophylaxis. This regimen was administered until the patient resumed normal ambulatory activity. RESULTS: Eight cases (0.33%) of deep vein thrombosis (DVT) were observed, but no pulmonary embolism was noted. In 6 cases (5 cholecystectomies with reverse Trendelenburg position and 1 inguinal hernia repair), the pneumoperitoneum was more than 2 h, and in 2 cases (1 rectopexy and 1 sigmoid colectomy for diverticulitis), more than 3 h. In 6 out of the 8 cases, the diagnosis of DVT was established after cessation of LMWH delivery, after the patients were discharged home, and before post-operative day 10. CONCLUSION: During laparoscopic surgery, long operations and reverse Trendelenburg position are potentiating factors to DVT. Heparin prophylaxis for laparoscopic procedures should continue at least until discharge, and continued prophylaxis after discharge should only be considered in individual patients at continued high risk. We also recommend using graduated compression stockings, maintaining a relatively low insufflation pressure, keeping use of the reverse Trendelenburg position to a minimum, and intermittently releasing the pneumoperitoneum in longer procedures.

Adolescent↗
PubMed2003

[Orthopedic surgery].

The incidence of proximal deep venous thrombosis after total hip or total knee replacement and surgery of hip fracture in patients in Japan is more than 10%, and intermittent pneumatic compression (foot pump) or anticoagulation therapy should be performed after these surgeries to prevent venous thromboembolism. Early surgery and early walking exercise are most effective prophylaxis of venous thromboembolism for patients with hip fracture. The incidence of proximal deep venous thrombosis after spine surgery is low, and that of deep venous thrombosis after general surgery of lower extremity is nuclear, and gradual compression stockings or foot pump should be performed after these surgeries.

Humans↗