CVI and PAD
Borderline cases for compression use, meeting challenges – PAD
Compression therapy despite PAD
Comorbidities can make treatment using compression products harder. The S2k Guidelines for Medical Compression Therapy specify clear contraindications.1 For example, advanced peripheral arterial disease is defined as a contraindication for compression therapy if one of the following parameters applies:
ABPI <0.5, arterial pressure at the ankle <60 mmHg, toe pressure <30 mmHg, or TcPO <20 mmHg at the instep.
If a patient is suffering from PAD with non-advanced characteristics outside the specified parameters, an ABPI of 0.9 to 0.5 in particular, indication-specific compression therapy can be implemented to treat vein problems for example. The Guidelines for Compression Therapy also make recommendations about the properties of the medical compression stockings.1
Medical compression stockings must therefore have the following properties to be suitable for treatment:
The Guidelines for Compression Therapy1 specify that a higher degree of stiffness is required for compression stockings used to treat conditions such as severe chronic venous insufficiency (CVI) or peripheral arterial disease. It must therefore be a characteristic of compression stockings that they are able to withstand an increase in circumference, during movement for example. This is referred to as ‘stiffness’. Underneath very stretchy materials, there is only a small increase in pressure (lower stiffness), while this pressure increase can be very high underneath less stretchy materials (higher stiffness).1 Based on their material properties, many compression stockings are unsuitable for compression therapy if patients also suffer from non-advanced PAD. With a low resting pressure, only a low working pressure, i.e. low contact pressure during movement, can generally be exerted because of a high degree of elasticity. If a higher working pressure is generated, most circular knit compression stockings also have a higher resting pressure, meaning a higher compression class, based on their long-stretch characteristics. Higher compression often results in MCS being perceived as uncomfortable, which may lead to them not being worn.
VenoTrain angioflow in patients with combined CVI / PAD after 14 days of wearing the product:
- Constant arterial circulation
- No negative skin changes (e.g. constriction, pressure points, skin damage)
- Patients appreciate the product because of its easy handling and great fit
- Patients rate the VenoTrain angioflow as very good to good
- Significant alleviation of CVI problems (e.g. reduction in pain as well as in feelings of heaviness and swelling of the legs)
VenoTrain angioflow
Bauerfeind’s specialist compression product for use despite PAD2
The VenoTrain angioflow is a medical compression stocking that, thanks to its unique combination of low resting pressure and high working pressure, can be used for compression therapy despite mild to moderate peripheral arterial disease (PAD, ABI <0.9 & >0.5; arterial pressure at the ankle >60 mmHg).2
“The Safety Study shows: no negative effects on arterial blood flow, no negative skin changes, patients rate the stocking as good to very good, with easy handling and a good fit, CVI problems reduce significantly.”3
Prof. Dr. Markus Stücker
Managing Director
Vein Center
University Hospital at Ruhr University Bochum
The short-stretch contoured knit ensures a low resting pressure and a high working pressure. This guarantees effective and safe3 compression therapy, despite accompanying PAD. The deep action of the VenoTrain angioflow supports the venous pumping function and alleviates the symptoms of a venous disorder, thus having a positive effect on quality of life. The specifically developed foot section with a low degree of compression provides particular comfort. Thanks to the reinforced instep, the soft, padded sole, and seam at the top above the toes, pressure points are prevented. The microfiber material guarantees a pleasantly soft wearing sensation. The 90° Easy Heel makes donning and doffing easier, thus supporting patient compliance. This is a great medical treatment benefit for older patients in particular or those with restrictions. An unpleasant pressure sensation during rest is prevented by low resting pressure exerted by compression class 1, meaning the stocking also guarantees great wearing comfort at rest.
Stockings that fit like a second skin: the VenoTrain angioflow is exclusively available as a custom-made solution. The specifically developed contoured knitting technique ensures a tailor-made and therefore perfect fit of the short-stretch knitted fabric for the particular demands of compression therapy in patients suffering from concomitant PAD.
With its short-stretch knitted fabric and the higher stiffness, the medical compression stocking complies with the Guidelines for Compression Therapy.1
Indications for compression therapy using the VenoTrain angioflow4
- Post-thrombotic syndrome
- Improvement in quality of life for chronic venous disorders
- Improvement of venous symptoms
- Prevention and treatment of venous edema
- Chronic venous disorders with skin changes (atrophie blanche, lipodermatosclerosis)
1 Rabe E et al. S2k Leitlinie: Medizinische Kompressionstherapie der Extremitäten mit Medizinischem Kompressionsstrumpf (MKS), Phlebologischem Kompressionsverband (PKV) und Medizinischen adaptiven Kompressionssystemen (MAK). Published online at: www.awmf.org/leitlinien/detail/ll/037-005.html (last accessed on June 5, 2023).
2 Medizinische Kompressionstherapie der Extremitäten mit Medizinischem Kompressionsstrumpf (MKS), Phlebologischem Kompressionsverband (PKV) und Medizinischen adaptiven Kompressionssystemen (MAK) – AWMF registration number: 037/005.
3 Stücker, M., Danneil, O., Dörler, M., Hoffmann, M., Kröger, E., & Reich‐Schupke, S. (2020). Sicherheit eines Kompressionsstrumpfes für Patienten mit chronischer venöser Insuffizienz (CVI) und peripherer arterieller Verschlusskrankheit (pAVK). JDDG: Journal of the German Dermatological Society, 18(3), 207-214; Published online at: https://onlinelibrary.wiley.com/doi/full/10.1111/ddg.14042_g (last accessed: August 23, 2024).
4 The complete list of indications can be found in the VenoTrain angioflow instructions for use.
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