The Myth of the Magic Stockings: Debunking the Claim that Lower Extremity Compression Stockings Prevent Blood Clots
As the man sat in the hospital room, a million thoughts raced through his mind. How could this have happened? He had followed all the advice, he had taken precautions, and yet, here he was, diagnosed with a deep venous thrombosis (DVT). He couldn’t understand it. One of the measures he had taken to prevent DVT was wearing lower extremity compression stockings during his flight. He had heard that they were supposed to prevent the occurrence of blood clots in the legs, so why did he develop one?
This experience led him to question the effectiveness of compression stockings in preventing DVT. Could it be that the information he had relied on was incorrect? The man decided to do some research on the topic, and what he found was surprising. There is a significant body of evidence that suggests that lower extremity compression stockings do not prevent the occurrence of DVT.
Before we discuss today’s topic, I want to briefly highlight my credentials to demonstrate that I am uniquely qualified to comment on this topic. As a board-certified cardiothoracic/vascular surgeon who founded the former Elite Laser Vein Center in 2005, I have performed well over 700 minimally invasive endovenous procedures. I also have also published in the field of venous and lymphatic disease and was the principal investigator in a two year long IRB approved study on the “Prevalence of MTHFR Polymorphisms in Venous Disease with or without Venous Thrombosis”.
DVT is a condition in which a blood clot forms in a deep vein, usually in the legs. It can lead to serious complications, such as a pulmonary embolism, if the clot breaks loose and travels to the lungs. Given the potentially life-threatening nature of DVT, it is crucial to identify effective preventive measures.
Lower extremity compression stockings are often recommended for individuals who are at risk of developing DVT, such as those on long-haul flights or bedridden patients. The logic behind their use is that the graded pressure exerted by the stockings on the legs helps to improve blood flow and prevent the formation of blood clots. However, the evidence supporting this theory is not as robust as one might expect.
Several studies have investigated the effectiveness of compression stockings in preventing DVT, and the results have been largely inconclusive. One systematic review and meta-analysis of randomized controlled trials, published in the journal Thrombosis Research, found that there was no significant difference in the incidence of DVT between individuals who wore compression stockings and those who did not.
Another study, published in the Journal of the American Medical Association, also failed to find a protective effect of compression stockings against DVT. The authors concluded that there was no evidence to support the routine use of compression stockings in preventing DVT, and that other preventive measures, such as regular exercise and hydration, may be more effective.
So why do compression stockings continue to be recommended as a preventive measure for DVT? The answer lies in the historical perception of their effectiveness. For many years, it was believed that compression stockings were beneficial in preventing DVT, and this belief has persisted despite the accumulating evidence to the contrary.
Additionally, there may be a financial incentive for the continued promotion of compression stockings as a preventive measure for DVT. The medical equipment industry has a vested interest in the widespread use of compression stockings, and this may influence the recommendations made by healthcare professionals.
In light of the evidence that suggests compression stockings do not prevent DVT, it is important for healthcare providers to reconsider their recommendations. Patients who are at risk of DVT should be made aware of the limited effectiveness of compression stockings and be given information about other preventive measures that may be more beneficial.
It is also crucial for further research to be conducted on this topic, to definitively establish whether compression stockings have a role to play in preventing DVT. Given the potential risks associated with DVT, it is essential to identify and implement effective preventive measures to protect the health and well-being of individuals at risk.
In conclusion, the man’s experience with developing a DVT while wearing compression stockings has led to a critical examination of their effectiveness in preventing this condition. The evidence suggests that lower extremity compression stockings do not prevent DVT, and healthcare providers should take this into consideration when making recommendations to at-risk patients. It is time to re-evaluate the role of compression stockings in DVT prevention and focus on evidence-based practices to effectively protect individuals from this potentially life-threatening condition.
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Hey Ryan-that was in 2016. The quality of evidence is very low. There is data for superficial vein thrombosis which is a manifestation of venous reflux. As you know, superficial vein thrombosis is not related to deep vein thrombosis. If you think about it, logically, even the highest compression 30 to 40 mmHg do nothing related to the deep venous system. Leg squeezers in the hospital do nothing regarding augmenting blood flow in their prevention of DVT. I know this is contrary to what most physicians think. They stimulate an endothelial relaxant factor. That’s why they work if you put them on the arm. The real reason to wear compression stockings on an airplane is because it does reduce edema in people who have superficial or deep vein reflux, and therefore reduces the acute manifestations....tired, heavy, painful, swollen legs at the end of a long flight. It’s the same reason why I tell people you should wear compression stockings if you have documented reflux and sit at the desk all day. The only way blood gets back to your heart is via walking or elevating your legs. The main thing to do when flying is to Montana stay very well hydrated and do some leg and feet exercises if they won’t let you walk up and down the aisle. In addition, if they have any family members that have unprovoked DVT, they should have a clotting workup definitely including a Factor V deficiency.
Hi! Interesting take on this, as I respect your expertise in this subject matter. However I did a recent post and cited a meta-analysis quoted by an UpToDate article on passenger safety on airplanes. In this environment it seems that there is a substantial reduction in DVT risk in those wearing compression stockings (symptom free/occult Dvt especially:
https://pubmed.ncbi.nlm.nih.gov/27624857/