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• EVCD use by pregnant women can be studied in the French Healthcare Claims Database. • Practice does not match recommendations by the French National Authority for Health. • EVCD dispensation was low, notably in women ≤ 30 years old and after vaginal delivery. • Fewer than half of all women with VTE risk factors or history were dispensed an EVCD. • Stockings were the most prescribed format regardless of period and prescriber. To describe the real-world use of Elastic Venous Compression Devices (EVCDs) during pregnancy and post-partum using data from a representative subset of the French National Health Insurance Claims Database (the Echantillon Généraliste des Bénéficiaires, EGB). Women aged 15–49 who were pregnant between 1st July 2017 and 15th June 2018 were identified in the EGB using pregnancy-specific acts (certain prenatal examinations or deliveries). Subgroups were defined by age, presence of Venous Thrombo-Embolism (VTE) risk factors, history of VTE, delivery type and time period. EVCD dispensations (format, prescriber, and date) were identified among those for "standard orthotics" using their unique reimbursement tariffs. Dispensation rates were computed for all subgroups, overall and by format and were compared. 15,528 pregnant women were included: 7,252 [46.7 %] deliveries (5,796 vaginal [79.9 %], 482 planned cesarean sections (C-sections) [6.7 %] and 974 unplanned C-Sections [13.4 %]), 2,734 (17.6 %) terminations and 5,542 (35.7 %) unknown outcomes. Overall, 4,919 (31.7 %) women were dispensed at least one EVCD. Ante-partum dispensation occurred in 43.1 % (n = 3,122) of women whose pregnancy led to a delivery. Dispensation rates were 17.3 % (n = 1,005), 46.7 % (n = 225) and 44.1 % (n = 430) after vaginal delivery, planned C-sections or unplanned C-sections, respectively. Overall, dispensation rates significantly increased with age, the presence of VTE risk factors, and a history of VTE (p < 0.01). EVCD dispensation was most frequent (17.0 %) during the 5th month of pregnancy. Among pregnant women who were dispensed at least one EVCD during ante- or post-partum, 69.0 % had one or two units of compression (27.1 % [one unit], 41.9 % [two units]). Stockings (48.6 %, n = 6,038) were dispensed significantly more frequently than socks (36.9 %, n = 4,586) and tights (14.5 %, n = 1,806) (p < 0.01). The main contributors to mechanical VTE prophylaxis were gynecologists (26.3 % of dispensations, n = 2,280), general practitioners (20.2 %, n = 1,749) and midwives (15.1 %, n = 1,314). Low observed dispensation rates highlight a discrepancy between the French National Authority for Health (Haute Autorité de Santé, HAS), recommending EVCDs use during pregnancy and after delivery, and the real-life use of EVCD. Prescription sensitization combined with targeted information campaigns for pregnant women would be beneficial to contribute to the prevention of VTE, a health problem for pregnant women. [ABSTRACT FROM AUTHOR]

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Background The main method for preventing thrombotic complications in patients with coronavirus infection is anticoagulant therapy (ACT). However, its use is not always possible, in particular in patients with bleeding. The only method of prevention in this case is elastic compression (EC) of the lower extremities.Aim of study To evaluate the effectiveness of lower extremity EC for the prevention of venous thromboembolic complications (VTEC) in patients with a new coronavirus infection.Material and methods The study was approved by the local Ethics Committee of the Ryazan State Medical University of the Ministry of Health of Russian Federation and registered on the ClinicalTrials.gov platform (identifier NCT05143567). The study included 69 patients without prophylactic compression (Group 1) and 65 patients who used prophylactic compression stockings (Group 2). The patients were treated in the covid hospital from July to November 2021. All patients had verified coronavirus infection, they took ACT and underwent ultrasound duplex scanning of the veins of the lower extremities upon admission, in the intensive care unit and upon discharge. We assessed the frequency of venous thromboembolic complications (VTEC), hemorrhagic complications, and mortality. To assess the severity of bleeding, the classification of the Committee of the International Society on Thrombosis and Haemostasis (ISTH) was used.Results In patients without prophylactic compression (Group 1) there were 7 VTEC cases (10.14%); deep vein thrombosis (DVT) — 4 (5.8%), pulmonary embolism (PE) — 3 (4.3%). All 6 cases (8.7%) with PE were fatal. It was noted that 2 cases of PE (2.8%) were verified upon autopsy, and not clinically. In patients of the 2nd group with the use of elastic compression, the overall incidence of VTEC was only one case (1.6%). When analyzing the frequency of bleeding in the 1st group, there was one pulmonary bleeding (1.4%), in the 2nd group there was also one case of intense intermuscular hematoma (1.6%). Significant bleeding was observed in one patient (1.4%) of the 1st group, and in 3 (4.8%) cases of the 2nd group. The minor bleeding was observed in 11 patients (15.9%) of the 1st group, and in 8 (12.7%) patients of the 2nd group. The mortality during hospitalization was 11 (15.9%) cases in patients of the 1st group (without EC) and 7 (11.1%) in patients of the 2nd group (with EC) (p=0.419).Conclusions The mortality in patients with coronavirus infection without compression therapy is higher than in patients with compression stockings (p=0.419). Patients wearing compression stockings in the hospital had a low incidence of VTEC (1.6% of cases in group 2 versus 10.14% of cases in group 1, p=0.039). The study groups had the same frequency of bleeding (group 1 — one case (1.4%), group 2 — one case (1.6%). The use of preventive compression at the inpatient stage of treatment of a new coronavirus infection makes it possible to prevent VTEC in patients with bleeding when anticoagulant therapy is not possible.

Objective: Although compression therapy (CT) is considered a crucial conservative treatment in chronic venous disease, strong evidence is missing for many clinical indications. This literature review aims to point out what strong evidence we have for CT and all the clinical scenarios where strong evidence still needs to be included., Methods: The research was conducted on MEDLINE with PubMed, Scopus and Web of Science. The time range was set between January 1980 and October 2022. Only articles in English were included., Results: The main problem with CT is the low scientific quality of many studies on compression. Consequently, we have robust data on the effectiveness of CT only for advanced venous insufficiency (C3-C6), deep vein thrombosis and lymphedema. We have data on the efficacy of compression for venous symptoms control and in sports recovery, but the low quality of studies cannot result in a strong recommendation. For compression in postvenous procedures, superficial venous thrombosis, thromboprophylaxis, post-thrombotic syndrome prevention and treatment, and sports performance, we have either no data or very debated data not allowing any recommendation., Conclusions: We need high-level scientific studies to assess if CT can be effective or definitely ineffective in the clinical indications where we still have a paucity of or contrasting data., Competing Interests: Disclosures None., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)