Ahmed Kayssi, Andrew Petrosoniak, Jeremy Levenstadt, Naomi Eisenberg, Graham Roche-Nagle
Department of Vascular Surgery, Toronto General Hospital, Toronto, ON, Canada.
OBJECTIVES: The post thrombotic syndrome (PTS) is a chronic condition that develops in 20% to 50% of patients after deep venous thrombosis (DVT). It is characterized by chronic pain, swelling and heaviness, and may result in ulceration. Elastic compression stockings (ECS) worn daily after DVT have been shown to reduce the incidence and severity of PTS. The aim of our study was to investigate practices and perceptions of physicians regarding adjunct therapies to anticoagulation in patients diagnosed with lover extremity DVT.
METHODS: An online survey was conducted of Canadian primary care staff physicians and residents (n=685) to investigate their attitudes towards prescription of ECS post diagnosis of DVT.
RESULTS: The results demonstrated that the majority of staff physicians (58%) and residents (58%) were unsure whether ECS were effective in preventing PTS and in managing venous symptoms. This resulted in only 12% of staff physicians and 26% of residents routinely prescribing ECS for below-knee DVTs. Only 10% of staff physicians and 12% of residents routinely prescribed ECS for above-knee DVTs. More than 70% of respondents were unsure about the optimal timing of initiation of ECS and duration of therapy. A majority of staff and resident respondents correctly predicted two out of the top three reasons for patient non-compliance (soreness and the need for assistance, but not cosmesis).
CONCLUSIONS: Daily use of graduated ECS after DVT appears to reduce the risk of PTS. Our results demonstrate that there is a lack of consensus among medics regarding ECS use after DVT. There is a need for widespread education regarding the latest evidence of the benefit of ECS after DVT.
AUTHOR DISCLOSURES: N. Eisenberg, Nothing to disclose; A. Kayssi, Nothing to disclose; J. Levenstadt, Nothing to disclose; A. Petrosoniak, Nothing to disclose; G. Roche-Nagle, Nothing to disclose.
Posted April 2012