Non-pharmaceutical measures for prevention of post-thrombotic syndrome

  • Review
  • Intervention




Post-thrombotic syndrome (PTS) is a long-term complication of deep vein thrombosis (DVT) characterised by chronic pain, swelling and skin changes in the affected limb. One in every three people with DVT will develop post-thrombotic complications within five years.


To determine the relative effectiveness of, and the rate of complications using, non-pharmaceutical interventions in people with DVT in the prevention of PTS.

Search methods

We searched the Cochrane Peripheral Vascular Diseases Group Specialised Trials register (last searched November 2005), and the Cochrane Central Register of Controlled Trials (CENTRAL) (last searched Issue 4, 2005). In addition, handsearching of non-listed journals and personal communications with researchers was undertaken.

Selection criteria

Randomised controlled trials (RCTs) of non-pharmaceutical interventions, such as bandaging and elastic stockings, in people with clinically confirmed DVT. The primary outcome was the occurrence of PTS. There were no restrictions on date or language. One author (DNK) identified and assessed titles and abstracts for relevance. This was verified independently by a second author (RS).

Data collection and analysis

Data extraction was undertaken independently by two authors (DNK, RS), using data extraction sheets.

Main results

Three RCTs that evaluated compression therapy were identified. Two studies compared elastic compression stockings with a pressure of 30-40 mm Hg at the ankle with no intervention applied directly after an episode of DVT. The other small study compared elastic compression stockings (pressure 20-30 mm Hg) with stockings that were one to two sizes too large in people one year after DVT. Overall, in the treatment group at two years, the use of elastic compression stockings was associated with a highly statistically significant reduction in the incidence of PTS with odds ratio (OR) 0.31 (95% confidence interval (CI) 0.20 to 0.48). In addition, the incidence of severe PTS was reduced from OR 0.39 (95% CI 0.20 to 0.76). In another RCT that considered the first nine days post DVT, no difference in the incidence of pulmonary embolism and size of thrombus in the femoral vein was found. A statistically significant reduction (P < 0.05) was found in pain, swelling and clinical scores, favouring the compression group.

Authors' conclusions

There is substantial evidence that elastic compression stockings reduce the occurrence of PTS after DVT. No serious adverse effects were mentioned in the studies. Hence, elastic compression stockings should be added to the treatment of DVT to prevent the development of post-thrombotic syndrome.




栓塞後症候群(postthrombotic syndrome,PTS)是一種深部靜脈栓塞的長期性併發症,其主要症狀為,在受到影響的肢體產生慢性疼痛、腫脹和皮膚的變化,每三個具有深部靜脈栓塞的患者中便會有一人會在五年內出現栓塞後症候群。




我們搜尋 Cochrane Peripheral Vascular Diseases Group Specialised Trials register (最後一次搜尋為 11月 2005年)及Cochrane Central Register of Controlled Trials (CENTRAL) (最後一次搜尋為 Issue 4, 2005年)。此外,還以人工搜尋未列在其中的期刊,並且與研究人員直接溝通討論。






有3個評估加壓療法的隨機性對照試驗被確認。其中的2個研究是在深部靜脈栓塞後,比較直接在腳踝施加30 – 40毫米汞柱壓力的彈性壓力襪和不介入治療的效果。還有一個小型試驗是在患者出現深部靜脈栓塞後一年內,比較使用彈性襪(20 – 30毫米汞柱壓力)和使用一至兩倍大之襪子的效果。整體來說,治療組在2年後,使用彈性加壓襪在統計學上將會明顯的降低栓塞後症候群的發生率,其OR值為0.31(95%CI值為0.20至0.48)。此外,嚴重的栓塞後症候群的發生率也會降低,OR值為0.39(95%CI值為0.20至0.76)。在另外一個隨機性對照試驗中,考量到發生深部靜脈栓塞後的前九天,對於肺動脈栓塞的發生和股靜脈栓塞之規模來說並沒有差異。在接受壓力治療的組別中,疼痛感、腫脹和臨床評分結果上都有顯著的降低(P值小於0.05)。




此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。



Plain language summary

Non-pharmaceutical measures for prevention of post-thrombotic syndrome

People with deep vein thrombosis can significantly reduce the chance of developing post-thrombotic syndrome by wearing elastic compression stockings. Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein. People with DVT often develop chronic pain, swelling and skin changes in the legs, called post-thrombotic syndrome (PTS). Elastic compression stockings are used to try to reduce the swelling and improve blood flow in the leg veins. The review found that people with DVT who wear elastic compression stockings are less likely to develop PTS. No adverse effects have been reported, but people with a weakened arterial blood supply may experience a worsening of their condition.