A review of the evidence for the efficacy of Anti-Embolism Stockings (AES) in Venous Thromboembolism (VTE) prevention

Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) is preventable, and venous thromboprophylaxis is ranked as the number one intervention for safer healthcare practices. Anti-Embolism Stockings that exert a graduated pressure range of 18, 14, 8, 10 and 8 mmHg (Sigel profile) from ankle to mid-thigh achieve maximum femoral venous blood flow velocity of 138.4% of the baseline and concomitantly prevent venous stasis. There is an abundance of evidence that Anti-Embolism Stockings alone or as an adjuvant are very efficacious in venous prophylaxis. Used alone, they reduce the incidence of DVT by over 60% and when used as an adjuvant to mechanical or pharmacological method of prophylaxis they reduce the incidence further up to 85%. Anti-Embolism Stockings are commercially available as knee and thigh length stockings and clinical opinions are divided as to whether they are equally effective. Current evidence supports the preferential use of thigh length stockings, and small randomized clinical trials hypothesizing the equal efficacy of knee length and thigh length stockings have been inconclusive. However, knee length stockings are cheaper, safe, more comfortable and very acceptable, and there is no evidence as yet that they are less effective than thigh length stockings. Large-scale trials are needed to answer this question reliably. (C) 2009 Elsevier Ltd. All rights reserved.