Therapeutic Outcomes of Graduated and Progressive Compression in Chronic Venous Disorders: A Meta-Analysis

Chronic venous disorders (CVD) are a common health problem affecting millions of people worldwide. Compression therapy, including graduated compression (graduated elastic compression stockings (GECS)) and progressive compression (progressive elastic compression stockings (PECS)), is a widely used treatment for CVD. This meta-analysis aimed to determine whether PECS provides superior clinical and hemodynamic outcomes compared to GECS in patients with CVDs. Clinical efficacy was defined as the disappearance or significant improvement in the sensation of fatigue or heaviness as reported by patients or assessed through validated symptom scales. A systematic literature search was conducted in PubMed, EMBASE, and Cochrane databases to identify randomized controlled trials (RCTs) comparing GECS and PECS for CVD from inception to November 23, 2024. The primary outcomes were clinical improvement, interface pressure, and ejection fraction. Secondary outcomes included tightness, ease of donning, and adverse events. Data were pooled using a random-effects meta-analysis model, with odds ratios (ORs) and mean differences (MDs) calculated along with 95% confidence intervals (CIs). Five RCTs involving 874 patients were included in the meta-analysis. PECS demonstrated significantly higher clinical improvement rates compared to GECS. Additionally, PECS resulted in a significantly higher interface pressure at level C (calf level), which is crucial for optimal venous hemodynamics. However, no significant difference was found between the two modalities in terms of improving ejection fraction. Secondary outcomes, such as tightness and ease of donning, showed no significant differences between the two groups. This meta-analysis suggests that PECS may be a more effective treatment option for CVD compared to GECS. However, further high-quality RCTs with longer follow-up periods are needed to confirm these findings and to assess the long-term benefits of PECS.