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Black holes in compression therapy: A quest for data
Giovanni Mosti1, Cees Wittens2, Alberto Caggiati3
1Clinica MD Barbantini, Angiology Department, Lucca, Italy.
Insights
Compression therapy (CT) shows robust evidence for advanced venous insufficiency, deep vein thrombosis, and lymphedema. However, more high-quality studies are needed to confirm CT efficacy in other clinical scenarios.
Area of Science:
- Vascular Medicine
- Medical Technology
- Evidence-Based Practice
Background:
- Compression therapy (CT) is a cornerstone conservative treatment for chronic venous disease.
- Despite its widespread use, robust scientific evidence supporting CT is lacking for numerous clinical indications.
Purpose of the Study:
- To review the existing strong evidence for compression therapy (CT) across various clinical scenarios.
- To identify areas where high-quality research is needed to establish definitive recommendations for CT.
Main Methods:
- A comprehensive literature search was performed using MEDLINE with PubMed, Scopus, and Web of Science.
- The search encompassed articles published in English between January 1980 and October 2022.
Main Results:
- Robust data supports CT effectiveness in advanced venous insufficiency (C3-C6), deep vein thrombosis, and lymphedema.
- Evidence for venous symptom control and sports recovery exists but is limited by study quality, precluding strong recommendations.
- Insufficient or conflicting data exists for CT in postvenous procedures, superficial venous thrombosis, thromboprophylaxis, and post-thrombotic syndrome.
Conclusions:
- High-level scientific studies are essential to determine the efficacy or ineffectiveness of CT in areas with limited or contradictory data.
- Further research is crucial to guide clinical practice and optimize the application of compression therapy.
Objective:
Although compression therapy (CT) is considered a crucial conservative treatment in chronic venous disease, strong evidence is missing for many clinical indications. This literature review aims to point out what strong evidence we have for CT and all the clinical scenarios where strong evidence still needs to be included.
Methods:
The research was conducted on MEDLINE with PubMed, Scopus and Web of Science. The time range was set between January 1980 and October 2022. Only articles in English were included.
Results:
The main problem with CT is the low scientific quality of many studies on compression. Consequently, we have robust data on the effectiveness of CT only for advanced venous insufficiency (C3-C6), deep vein thrombosis and lymphedema. We have data on the efficacy of compression for venous symptoms control and in sports recovery, but the low quality of studies cannot result in a strong recommendation. For compression in postvenous procedures, superficial venous thrombosis, thromboprophylaxis, post-thrombotic syndrome prevention and treatment, and sports performance, we have either no data or very debated data not allowing any recommendation.
Conclusions:
We need high-level scientific studies to assess if CT can be effective or definitely ineffective in the clinical indications where we still have a paucity of or contrasting data.
