Abstract
With increasing age, it is increasingly common for patients to develop both chronic venous insufficiency (CVI) and peripheral artery disease (PAD). While there are special compression bandage systems commercially available for individuals thus affected, appropriate compression stockings have previously not been available. In the present study, we investigated the safety and effectiveness of a type of compression stocking specifically designed for this patient group (VenoTrain® angioflow, Bauerfeind Germany, German compression class 1 with high stiffness). In a prospective case series, we included patients with both CVI (C3-C5 disease according to CEAP classification) and PAD (ankle-brachial index of <0.9 and >0.5; absolute ankle systolic pressure of >60mmHg). Primary outcome measures consisted of 1) safety in terms of PAD, as determined by measuring acral pressure using acral photoplethysmography (APPG), and 2) effectiveness in terms of CVI symptoms, as assessed by using a suitable questionnaire (VVSymQ). Fifty patients were evaluated (mean age: 67.1; mean ankle-brachial index: 0.75 ±0.77). Fifteen patients had stage IIa PAD (according to Fontaine); 15, stageIIb; the remainder, stage I disease. Thirty-one patients had stage C3 CVI (according to CEAP classification); 16 patients, stage C4; and three patients, stage C5 disease. Immediately after donning the medical compression stocking, systolic arterial pressure in the big toe increased significantly (from 83.3mmHg ±27.6mmHg to 90.8mmHg ±24.1mmHg) (p=0.026). The VVSymQ score dropped significantly from 5.0 ±4.95 points to 1.4 ±2.26 points (p<0.001), thus reflecting an improvement in CVI symptoms. The compression stocking tested herein is safe for individuals with an ankle brachial index ≥0.5. Skin damage was not observed.
Highlights
With increasing age, it is increasingly common for patients to develop both chronic venous insufficiency (CVI) and peripheral artery disease (PAD)
The present study investigated a novel medical compression stocking (MCS) for the treatment of individuals with both conditions
After 14 days of daily use, the systolic pressure in the big toe while wearing the compression stocking (80.6 ± 25.2 mmHg) did not differ from that measured at baseline; neither from that measured directly prior to initial application of the compression stocking (83.3 ± 27.6 mmHg) (Figure 1)
Summary
It is increasingly common for patients to develop both chronic venous insufficiency (CVI) and peripheral artery disease (PAD). Patients and Methods: In a prospective case series, we included patients with both CVI (C3–C5 disease according to CEAP classification) and PAD (ankle-brachial index of < 0.9 and > 0.5; absolute ankle systolic pressure of > 60 mmHg). Primary outcome measures consisted of 1) safety in terms of PAD, as determined by measuring acral pressure using acral photoplethysmography (APPG), and 2) effectiveness in terms of CVI symptoms, as assessed by using a suitable questionnaire (VVSymQ). After donning the medical compression stocking, systolic arterial pressure in the big toe increased significantly (from 83.3 mmHg ± 27.6 mmHg to 90.8 mmHg ± 24.1 mmHg) (p = 0.026). Conclusions: The compression stocking tested is safe for individuals with an ankle brachial index ≥ 0.5.
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