In most of these clinical conditions, the presence of leg swelling is usually secondary to the primary disease, which suggests focusing the treatment on the primary pathology and using, if possible, the other measures (including compression) as supportive treatment only. Leg oedema is a relatively common occurrence in the adult population in addition to the clinical situations mentioned previously, a variety of other conditions can result in lower extremity swelling, including hypoproteinemia, obesity, renal failure, and chronic heart failure (CHF). The other groups of indications are focused on venous thromboembolism prophylaxis and treatment and venous leg ulcer therapy. The use of MC in more severe classes of CHF (NYHA III and IV) should be the subject of future clinical studies to select the safest and most efficient compression method as well as to select the patients who benefit most from this kind of treatment.Ĭompression treatment, including medical compression stocking (MCS), is one of the commonly used treatment methods in patients with various types of leg oedema, including primary and secondary chronic venous disease and lymphedemaĪlso among the current MCS indications are leg swelling prevention in both chronic venous disease patients and healthy individuals at risk of leg swelling (e.g. The use of local leg compression can be considered stable CHF patients without decompensated heart function for both CHF‐related oedema treatment and for treatment of the concomitant diseases leading to leg swelling occurrence. In a pilot study performed in a small cohort of CHF patients, electrical calf stimulation use resulted in a reduction in the lean mass of the legs without cardiac function worsening. In the manual lymphatic drainage study, aside from expected leg circumference reduction, no clinical worsening was observed. An application of the multilayer bandages in NYHA classes III and IV patients lead a significant increase in the right arterial pressure and lead to transient deterioration of the right and the left ventricular functions. The transient and rapid increase in the human atrial natriuretic peptide, after an application of the MC stocking in New York Heart Association (NYHA) class II patients was observed without clinical exacerbation. The use of the intermittent pneumatic compression in CHF patients significantly increases the right auricular pressure and mean pulmonary artery pressures as well as decreases systemic vascular resistance in most patients without the clinical worsening. The current evidence is based on non‐randomized studies, small study cohorts, as well as very heterogenous populations. In studies performed on CHF populations, manual lymphatic drainage, MC stocking, multilayer bandaged, as well as intermittent pneumatic compression or electric calf stimulations were used. The available studies dedicated the comprehensive management of leg swelling using MC in CHF patients published in the English language literature till December 2019 were evaluated in term of the treatment efficacy and safety. In the study, an overview of the current knowledge related to the benefits and risk of using MC in the supportive treatment of leg oedema in CHF patients is presented. Medical compression (MC) treatment is one of the basic methods of leg oedema elimination in patients with chronic venous disease and lymphedema, but it is not routinely considered in subjects with CHF‐related swelling. The presence of chronic heart failure (CHF) results in a significant risk of leg oedema.
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