The effect of graded compression elastic stockings on the lower leg venous system during daily activity

AbstractPurpose: We evaluated the effects of wearing 20 to 30 mm Hg gradient thigh-length stockings during daily activity on the lower leg venous system. Methods: Twenty-one healthy women volunteers, aged 39 ± 12 years, were examined. One subject was clinical class 4, one was class 2, two were class 1, and the remainder were class 0. The diameter of the posterior tibial, peroneal, and greater saphenous veins were measured at midcalf by means of bilateral duplex ultrasound scanning; calf circumference was measured at the same level. In addition, the number and caliber of all detectable medial calf perforating veins were recorded. Each subject was examined on two separate days, one while wearing the gradient stockings and one not wearing them. Baseline measurements were made on each day before the subjects began their workday, with follow-up measurements made after approximately 4.5 hours of normal activity. Results: Calf circumference increased an average of 23.8 ± 10.1 mm without stockings (P < .001) and decreased by 5.2 ± 7.0 mm when wearing stockings (P = .003). The number of detected perforating veins increased without stockings by 1.8 ± 2.0 at the follow-up examination (P = .002); with stockings, the change was 0.4 ± 1.2 (P = NS). Conclusion: Graded compression elastic stockings help preserve lower leg venous caliber and tone throughout the deep, superficial, and perforating venous systems during normal ambulatory activity, and this may, in part, explain their beneficial effects. (J Vasc Surg 1999;30:830-5.