The impact of graduated compression stockings on calf-vein deformation and blood velocity in patients awaiting total knee arthroplasty

Zaikai Zhuang,Yao Yao,Dongyang Chen,Ying Shen,Yexian Wang,Qing Jiang

doi:10.1186/s12891-021-04603-z

Zaikai Zhuang, Yao Yao + Show 4 more

Open Access

https://doi.org/10.1186/s12891-021-04603-z

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Abstract

ObjectivesThis study was designed to explore venous deformation of the lower extremities and the changes in venous hemodynamics in supine position before and after wearing graduated elastic stockings in patients awaiting total knee arthroplasty (TKA).MethodThe leg veins of 21 elderly patients awaiting TKA were imaged in the supine position with and without knee-length graduated compression stockings (GCS) according to a fixed protocol. Measured parameters including the lateromedial (LM) diameter, anteroposterior (AP) diameter, and cross-sectional area (CSA) of the great saphenous vein (GSV), gastrocnemius vein (GV), soleus vein (SV), posterior tibial vein (PTV), fibular vein (FV), and anterior tibial vein (ATV). In addition, the mean and maximum velocities of the popliteal vein (PV) and superficial femoral vein (FSV) were measured.ResultsGCS-related compression was observed for all the measured veins. Maximal reduction was observed for the GV and SV, whereas the GSV exhibited the lowest degree of GCS-related compression. The mean cross-sectional area reduction values associated with GCS were 33.1 ± 41.2 % for the GSV, 94.8 ± 11.1 % for the GV, and 85.6 ± 20.3 % for the SV, while the mean reduction of anteroposterior diameter was 18.1 ± 34.5 % for the GSV, 89.0 ± 22.5 % for the GV, and 72.9 ± 35.1 % for the SV, and the mean reduction of the lateromedial diameter was 25.9 ± 36.4 % for the GSV, 89.6 ± 19.6 % for the GV, 78.2 ± 28.3 % for the SV. No significant GCS-related changes in blood velocity in the superficial femoral veins or popliteal veins were detected.ConclusionsFor elderly patients awaiting TKA, knee-length GCS can significantly reduce calf vein dilation while at rest in the supine position, with the greatest reductions being observed for the soleus and gastrocnemius veins. These data might help provide a theoretical basis for the GCS in reducing incidence of deep vein thrombosis in patients undergoing TKA.

Highlights

Deep vein thrombosis (DVT) is defined as the occurrence of a blood clot within a deep vein, most often in the legs
Maximal reduction was observed for the gastrocnemius vein (GV) and soleus vein (SV), whereas the great saphenous vein (GSV) exhibited the lowest degree of graduated compression stockings (GCS)-related compression
For elderly patients awaiting total knee arthroplasty (TKA), knee-length GCS can significantly reduce calf vein dilation while at rest in the supine position, with the greatest reductions being observed for the soleus and gastrocnemius veins

Summary

Introduction

Deep vein thrombosis (DVT) is defined as the occurrence of a blood clot within a deep vein, most often in the legs. Thrombus formation primarily occurs in the context of immobilization, the rate of DVT following knee arthroplasty ranges from 41 to 85 % without thromboprophylaxis [1, 2]. Some prior reports have suggested that up to 50 % of patients may develop post-thrombotic syndrome (PTS) following DVT, potentially reducing their disease-specific quality of life [4, 5]. Preventing DVT following knee arthroplasty is essential. The intermuscular vein thrombosis is the most common distal lower limb thrombus [6]. We and others have previously reported that soleus vein (SV) dilatation is an independent predictor of DVT risk following major orthopedic surgery [7, 8]

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