Effects of graduated compression stockings with different pressure profiles on lower-limb venous structures and haemodynamics

摘要

Introduction: Graduated compression stockings (GCS) are one of the essential mechanical therapeutic approaches used in prevention and treatment of venous diseases. Pressure levels and gradient distribution are the two determined parameters influencing the performance of GCS products. However, the effects of GCS with different pressure profiles on venous function remain controversial in practical use. Objective: To determine the physiological effects of GCS with different pressure levels and gradient distribution profiles on the venous function of the lower extremities. Methods: At specific testing points along the long and short saphenous veins (LSV, SSV) and popliteal veins (PV) of the lower extremities, Doppler ultrasound techniques were used to examine venous cross-sectional areas (VA, cm 2), the venous peak blood flow (PVpeak, cm/sec) and venous mean blood flow (PVmean, cm/sec) velocities in twelve female subjects wearing GCS with varying pressure profiles in a controlled laboratory environment. The Doppler examination was conducted three times during the 4-hour period (after wearing GCS for 1 minute, 70 minutes, and 170 minutes) in each subject. Results: The pressure levels of GCS and duration of wear had statistically significant influences on the venous anatomy and venous haemodynamics. GCS with light, mild, moderate and strong pressures increased the popliteal PVpeak by 9.64%, 25.74%, 29.91% and 26.47%, respectively, and significantly decreased the VA. The GCS maintained these venous haemodynamics over time. No significant differences in blood flow were found between the mild, moderate and strong pressure GCS. Conclusion: The application of GCS with light and mild compression profiles appear to be effective in achieving a reduction in venous dilation and venous pooling, and improving venous return in the lower extremities. GCS with lighter pressures may be more suitable for subjects whose daily work requires long-term inactive standing or sitting, and GCS with mild pressure appear to be sufficient for most clinical applications.