Comparative Efficacy of Knee-High Versus Thigh- High Compression Stockings in Managing Chronic Venous Insufficiency: A Retrospective Comparative Cohort Study

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Gojayev F., OZÇOLAK B., POLAT A.

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, cilt.33, sa.3, ss.259-266, 2026 (TRDizin)

Özet

Objective To compare the clinical efficacy and patient adherence of knee-high versus thigh-high compression stockings, each combined with calcium dobesilate, versus phar- macologic therapy alone in the conservative manage- ment of chronic venous insufficiency (CVI). Material and Method This retrospective comparative cohort included 85 screened and 77 analyzed adults with duplex ultra- sound–confirmed CVI (CEAP C1–C5) treated at a single tertiary center (January–June 2023). Patients received: (Group 1) knee-high stockings (European Class II, 23–32 mmHg) + calcium dobesilate 500 mg bid; (Group 2) thigh-high stockings (Class II) + dobesi- late; or (Group 3) dobesilate alone. Each compression patient was provided two pairs and instructed for daily wear for≥3 months. Adherence (≥80% of prescribed days/doses) was assessed via diaries, monthly calls, in-clinic inspection (compression), and pill counts/ self-report (drug). Disease severity was evaluated by Venous Clinical Severity Score (VCSS) at 3 and 6 months. Non-parametric tests with effect sizes were used. Results Among 77 analyzed patients, Group 1 (knee-high + dobesilate) achieved the greatest improvement, with median VCSS decreasing from 8.5 (IQR 7–10) to 4.9 (IQR 4–6) at 6 months (p < 0.01, r = 0.63). Group 2 (thigh-high + dobesilate) improved modestly (8.7 → 6.9; p < 0.05, r = 0.42) while Group 3 (dobesilate alone) showed no significant change (8.3 → 7.7; p > 0.05). Patient-reported symptomatic relief occurred in 87.1%, 34.8%, and 34.8% of Groups 1–3, respectively (φ = 0.55, p < 0.001). Compression adherence was ~90% for knee-high, ~22% for thigh-high users, and phar- macologic adherence exceeded 85% in all groups. No major adverse events or discontinuations occurred. Conclusion Knee-high stockings plus calcium dobesilate yielded superior clinical improvement and adherence versus thigh-high stockings or pharmacologic therapy alone. Comfort and usability were key adherence drivers; knee-high Class II compression should be prioritized in most CVI patients, with pharmacologic therapy as a useful adjunct, particularly in early stages.