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Therapeutic Outcomes of Graduated and Progressive Compression in Chronic Venous Disorders: A Meta-Analysis
Hosam Hadi Hassan Awaji1, Ibrahim Adil Hamadelniel Alhadi2,3,4, Albasil Hamoud E Badawi5
1Department of Preventive Medicine, North West Armed Forces Hospital, Tabuk, SAU.
Cureus
|December 8, 2025
Summary
Progressive elastic compression stockings (PECS) show better clinical improvement and higher interface pressure for chronic venous disorders (CVD) compared to graduated elastic compression stockings (GECS). Further research is needed for long-term benefits.
Area of Science:
- Vascular Medicine
- Medical Devices
- Evidence-Based Medicine
Background:
- Chronic venous disorders (CVD) affect millions globally, with compression therapy being a primary treatment.
- Graduated elastic compression stockings (GECS) and progressive elastic compression stockings (PECS) are common interventions for CVD.
- The comparative efficacy of PECS versus GECS for CVD requires further investigation.
Purpose of the Study:
- To compare the clinical and hemodynamic outcomes of progressive elastic compression stockings (PECS) against graduated elastic compression stockings (GECS) in patients with chronic venous disorders (CVD).
- To evaluate differences in clinical improvement, interface pressure, and ejection fraction between PECS and GECS.
Main Methods:
- A systematic literature search was performed in PubMed, EMBASE, and Cochrane databases for randomized controlled trials (RCTs) comparing PECS and GECS for CVD.
- Five RCTs with 874 patients were included in a random-effects meta-analysis.
- Primary outcomes included clinical improvement, interface pressure, and ejection fraction; secondary outcomes included tightness, ease of donning, and adverse events.
Main Results:
- PECS demonstrated significantly higher clinical improvement rates compared to GECS for CVD symptoms.
- PECS achieved significantly higher interface pressure at the calf level, important for venous hemodynamics.
- No significant differences were observed in ejection fraction, tightness, or ease of donning between PECS and GECS.
Conclusions:
- Progressive elastic compression stockings (PECS) may offer superior clinical efficacy for chronic venous disorders (CVD) compared to graduated elastic compression stockings (GECS).
- Higher interface pressure with PECS suggests improved hemodynamic support.
- Further high-quality RCTs with extended follow-up are necessary to confirm these findings and assess long-term benefits.
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