INCREASING COMPRESSION
Compression:
The Not-So-Secret Weapon of
Vein Specialists
By Cindy Asbjornsen, DO, FACPh
nous laser ablation (EVLA) and sclerotherapy have been joined by newer procedures, including mechanico-chemical ablation, and cyanocryalate adhesives. We often turn to a tried and true technol- ogy to help patients manage their vein symptoms: compression.
T The Basics
Graduated compression stockings can prevent vein problems from occurring, relieve symptoms, and decrease the likelihood of a blood clot. Patients frequently report that their symptoms are significantly improved, if not completely allevi- ated, while wearing compression.
Compression therapy provides an alternative for patients
who opt for a more conservative treatment. Stockings can be worn for years as a long-term option for managing symptoms of venous disease.
Venous disease is defined as the impairment of blood flow
towards the heart. Healthy veins have valves that open and close to assist the return of blood to the heart. Venous disease occurs if these valves become damaged, allowing the backward flow of blood in the legs. When blood cannot be properly returned through the vein, it can pool, leading to a feeling of heaviness and fatigue and cause varicose veins, among other problems.
Medical compression provides a gradient of pressure against the leg; the pressure is highest at the foot and ankle and gradually decreases as the garment rises up the leg. This pressure gradient makes it easier for the body to pump blood up towards the heart (the normal direction) and more difficult for gravity to pull blood downward. Compression increases the pressure in the subcuta-
he best board-certified vein specialists are always looking for innovative ways to treat patients’ vein disease at the source of the problem. Minimally invasive treatments such as endove-
neous tissue, thereby helping to reduce and prevent swelling by moving excess fluid back into the capillaries.
Gradient compression is expressed in millimeters of mer-
cury, or mmHg. It is the measurement of how much compression or squeeze that is placed on the leg; the higher the number, the greater the compression. Stockings are graded on the basis of the strength of the compression at the ankle. Commonly prescribed strengths include 15-20 mmHg for spider veins or patients with varicose veins but only mild symptoms or swelling; 20-30 mmHg for mild to moderate varicose veins; and 30-40 mmHg for patients with varicose veins associated with symptoms such as pain and swelling. For conditions such as lymphedema, 50-60 mmHg stock- ings or inelastic bandages are most effective.
Compression Gains Traction Athletic compression and post-thrombotic (clot) compression
garments, such as those worn by tennis star Venus Williams, have raised consumers’ awareness of compression. Add to that frequent travel stories about so-called “economy-class syndrome,” and public awareness of compression appears to be growing. In recent years, there has been increased consumer interest in compres- sion for occupational use as more teachers, hair stylists, and other professionals who are on their feet all day look for relief for their tired, achy legs.
Now that there is a multitude of products to choose from,
however, consumers should be judicious about what they are pur- chasing and why. Non-medical compression may help your legs feel better, but if you have varicosities, venous reflux, edema, or lymphatic issues, then it could actually be dangerous to wear con- sumer compression products if they’re not the appropriate size or don’t have the structure of a medical-grade compression garment.
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