Compression Stockings May Reduce Postthrombotic Syndrome

To the Editor: Dr. Patel and colleagues' article about peripheral edema discussed venous thromboembolism as a potential etiology for peripheral edema.¹ In their discussion about the treatment of deep venous thrombosis, the authors suggest that compression stockings prevent the development of postthrombotic syndrome.¹ To clarify, the Cochrane review concluded that compression stockings “may” reduce the occurrence of postthrombotic syndrome; however, the review stated that the evidence for that recommendation is of low quality.² The 2020 American Society of Hematology guidelines for the management of venous thromboembolism recommended specifically against the routine use of compression stockings to prevent postthrombotic syndrome.³ Per the guideline, compression stockings “may help to reduce edema and pain associated with acute deep venous thrombosis in selected patients.”³

Editor's Note: This letter was sent to the authors of “Peripheral Edema: Evaluation and Management in Primary Care,” who declined to reply.