Compression therapy after invasive treatment of superficial veins of the lower extremities

Clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology

Fedor Lurie, Brajesh K. Lal, Pier Luigi Antignani, John Blebea, Ruth Bush, Joseph Caprini, Alun Davies, Mark Forrestal, Glenn Jacobowitz, Evi Kalodiki, Lois Killewich, Joann Lohr, Harry Ma, Giovanni Mosti, Hugo Partsch, Thom W Rooke, Thomas Wakefield

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Guideline 1.1: Compression after thermal ablation or stripping of the saphenous veins. When possible, we suggest compression (elastic stockings or wraps) should be used after surgical or thermal procedures to eliminate varicose veins. [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 1.2: Dose of compression after thermal ablation or stripping of the varicose veins. If compression dressings are to be used postprocedurally in patients undergoing ablation or surgical procedures on the saphenous veins, those providing pressures >20 mm Hg together with eccentric pads placed directly over the vein ablated or operated on provide the greatest reduction in postoperative pain. [GRADE - 2; LEVEL OF EVIDENCE - B] Guideline 2.1: Duration of compression therapy after thermal ablation or stripping of the saphenous veins. In the absence of convincing evidence, we recommend best clinical judgment to determine the duration of compression therapy after treatment. [BEST PRACTICE] Guideline 3.1: Compression therapy after sclerotherapy. We suggest compression therapy immediately after treatment of superficial veins with sclerotherapy to improve outcomes of sclerotherapy. [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 3.2: Duration of compression therapy after sclerotherapy. In the absence of convincing evidence, we recommend best clinical judgment to determine the duration of compression therapy after sclerotherapy. [BEST PRACTICE] Guideline 4.1: Compression after superficial vein treatment in patients with a venous leg ulcer. In a patient with a venous leg ulcer, we recommend compression therapy over no compression therapy to increase venous leg ulcer healing rate and to decrease the risk of ulcer recurrence. [GRADE - 1; LEVEL OF EVIDENCE - B] Guideline 4.2: Compression after superficial vein treatment in patients with a mixed arterial and venous leg ulcer. In a patient with a venous leg ulcer and underlying arterial disease, we suggest limiting the use of compression to patients with ankle-brachial index exceeding 0.5 or if absolute ankle pressure is >60 mm Hg. [GRADE - 2; LEVEL OF EVIDENCE - C]

Original languageEnglish (US)
Pages (from-to)17-28
Number of pages12
JournalJournal of Vascular Surgery: Venous and Lymphatic Disorders
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2019

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Cardiology
Practice Guidelines
Lower Extremity
Veins
Varicose Ulcer
Leg Ulcer
Sclerotherapy
Guidelines
Saphenous Vein
Therapeutics
Hot Temperature
Compression Stockings
Varicose Veins
Compression Bandages
Pressure
Ankle Brachial Index
Bandages
Postoperative Pain
Ankle
Ulcer

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Compression therapy after invasive treatment of superficial veins of the lower extremities : Clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology. / Lurie, Fedor; Lal, Brajesh K.; Antignani, Pier Luigi; Blebea, John; Bush, Ruth; Caprini, Joseph; Davies, Alun; Forrestal, Mark; Jacobowitz, Glenn; Kalodiki, Evi; Killewich, Lois; Lohr, Joann; Ma, Harry; Mosti, Giovanni; Partsch, Hugo; Rooke, Thom W; Wakefield, Thomas.

In: Journal of Vascular Surgery: Venous and Lymphatic Disorders, Vol. 7, No. 1, 01.01.2019, p. 17-28.

Research output: Contribution to journalArticle

Lurie, Fedor ; Lal, Brajesh K. ; Antignani, Pier Luigi ; Blebea, John ; Bush, Ruth ; Caprini, Joseph ; Davies, Alun ; Forrestal, Mark ; Jacobowitz, Glenn ; Kalodiki, Evi ; Killewich, Lois ; Lohr, Joann ; Ma, Harry ; Mosti, Giovanni ; Partsch, Hugo ; Rooke, Thom W ; Wakefield, Thomas. / Compression therapy after invasive treatment of superficial veins of the lower extremities : Clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology. In: Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2019 ; Vol. 7, No. 1. pp. 17-28.
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N2 - Guideline 1.1: Compression after thermal ablation or stripping of the saphenous veins. When possible, we suggest compression (elastic stockings or wraps) should be used after surgical or thermal procedures to eliminate varicose veins. [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 1.2: Dose of compression after thermal ablation or stripping of the varicose veins. If compression dressings are to be used postprocedurally in patients undergoing ablation or surgical procedures on the saphenous veins, those providing pressures >20 mm Hg together with eccentric pads placed directly over the vein ablated or operated on provide the greatest reduction in postoperative pain. [GRADE - 2; LEVEL OF EVIDENCE - B] Guideline 2.1: Duration of compression therapy after thermal ablation or stripping of the saphenous veins. In the absence of convincing evidence, we recommend best clinical judgment to determine the duration of compression therapy after treatment. [BEST PRACTICE] Guideline 3.1: Compression therapy after sclerotherapy. We suggest compression therapy immediately after treatment of superficial veins with sclerotherapy to improve outcomes of sclerotherapy. [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 3.2: Duration of compression therapy after sclerotherapy. In the absence of convincing evidence, we recommend best clinical judgment to determine the duration of compression therapy after sclerotherapy. [BEST PRACTICE] Guideline 4.1: Compression after superficial vein treatment in patients with a venous leg ulcer. In a patient with a venous leg ulcer, we recommend compression therapy over no compression therapy to increase venous leg ulcer healing rate and to decrease the risk of ulcer recurrence. [GRADE - 1; LEVEL OF EVIDENCE - B] Guideline 4.2: Compression after superficial vein treatment in patients with a mixed arterial and venous leg ulcer. In a patient with a venous leg ulcer and underlying arterial disease, we suggest limiting the use of compression to patients with ankle-brachial index exceeding 0.5 or if absolute ankle pressure is >60 mm Hg. [GRADE - 2; LEVEL OF EVIDENCE - C]

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