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Do Compression Stockings Potentiate the Fibrinolytic Capacity of the Lower Limbs?

Patients with varicose veins and liposclerosis have been shown to have impaired fibrinolytic activity1. Furthermore, fibrinolytic activity is much reduced in the lower than in the upper limbs, probably due to the difference in hydrostatic pressure. After 2–10 days bed rest a significant increase in potential is observed2. Compression support stockings can exert 30–40 mmHg of pressure which is 50% of the normal hydrostatic pressure. Therefore does the long term use of such stockings cause a significant increase in fibrinolytic potential? Seventeen patients (10 male, 7 female; mean age 52.8 +/— 9.8 yrs) with features of liposclerosis were studied. Pre- and post-euglobulin clot lysis times (ELT) were measured in the right arm and both legs using a 10 min occlusion time. The patients contralateral leg served as the control. Sigvaris stockings were made for each patient to wear on the designated leg only. Measurements were repeated after 1 and 3 months of use with the stocking in situ and after 30 min bed rest. Patients were instructed to wear the stockings at all times during the day. There were no significant differences in the pre-occlusion values between the arm or the lower limb groups throughout the study. Lower limb post occlusion ELT values were significantly higher in both the affected limb (p < 0.002) and the patients control limb (p < 0.002), than in the arm. This relationship was constant throughout the study period. No significant potentiation was seen after either 1 or 3 months of use. There were no new areas of ulceration throughout the study period. Thus any clinical benefit arising from the use of compression stockings is not from potentiation of local fibrinolysis.