@article{ThiemeLinnemannMuehlbergetal., author = {Thieme, Dorothea and Linnemann, Birgit and M{\"u}hlberg, Katja Sibylle and Noppeney, Thomas and Kreutz, Maria and Thieme, Marcus}, title = {Compression Therapy in Acute Deep Venous Thrombosis of the Lower Limb and for the Prevention of Post-Thrombotic Syndrome}, series = {Deutsches {\"A}rzteblatt International}, volume = {121}, journal = {Deutsches {\"A}rzteblatt International}, number = {6}, address = {Berlin}, doi = {10.3238/arztebl.m2024.0001}, pages = {188 -- 194}, abstract = {Background: After an acute deep venous thrombosis (DVT) of the lower limb, 20\% to 63\% of patients develop post-thrombotic syndrome (PTS). In this review, we address the efficacy of compression therapy in the treatment of acute DVT of the lower limb, and for the prevention of PTS. Methods: 12 randomized controlled trials (RCTs) and one meta-analysis, with a total of 3751 patients, were identified in a structured literature search. Results: Two RCTs showed that adding compression therapy to drug treatment in the first 9 days of the acute phase of lower limb DVT led to more rapid pain relief (p<0.050) and less swelling (remaining difference in circumference, 1 cm versus 3 cm, p<0.050). As for the prevention of PTS, four RCTs showed a short-term benefit or no benefit of compression therapy. In three further RCTs, medical compression stockings (MCS) brought about a 16\% to 27\% absolute reduction of the frequency and severity of PTS (47\% vs. 20 \%, p<0.001; 40\% vs. 21\% (95\% confidence intervals [29.9; 50.1] and [12.7; 29.5], respectively; and 58\% vs. 42\%, relative risk [RR] 0.73 [0,55; 0.96]). The benefit of MCS was also confirmed in a recent meta-analysis (RR 0.66 [0.44; 0.99], I2 = 88\%). Thigh-length MCS were not superior to knee-length MCS for the prevention of PTS (33\% vs. 36\%, hazard ratio [HR] 0.93 [0.62; 1.41]). Individual, symptomoriented tailoring of the duration of treatment was not inferior to a fixed treatment duration of 24 months (29\% vs. 28\%; odds ratio [OR] 1.06 [0.78;1.44]). Conclusion: Compression therapy relieves symptoms in acute DVT and lessens the frequency and severity of PTS. It is therefore recommended as standard treatment.}, language = {en} }