Treatment
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Primary Prevention
Primary Prevention–Clinical CEAP C3-4 Primary Venous Disease
➤ In patients with clinical CEAP C3-4 disease due to primary valvular
reflux, we recommend compression, 20–30 mm Hg, knee or thigh
high. (2-C)
Primary Prevention–Clinical CEAP C1-4 Post-thrombotic Venous
Disease
➤ In patients with clinical CEAP C1-4 disease related to prior deep
venous thrombosis (DVT), we recommend compression, 30–40 mm
Hg, knee or thigh high. (1-B)
Guideline 8.3. Primary Prevention–Acute DVT Treatment
➤ As post-thrombotic syndrome is a common preceding event for
venous leg ulcers, we recommend current evidence-based therapies
for acute DVT treatment. (1-B)
➤ We suggest use of low-molecular-weight heparin over vitamin K
antagonist therapy of 3-month duration to decrease postthrombotic
syndrome. (2-B)
➤ We suggest catheter-directed thrombolysis in patients with low
bleeding risk with iliofemoral DVT of duration <14 days. (2-B)
Primary Prevention–Education Measures
➤ In patients with C1-4 disease, we suggest patient and family
education, regular exercise, leg elevation when at rest, careful skin
care, weight control, and appropriately fitting foot wear. (BP)
Primary Prevention–Operative Therapy
➤ In patients with asymptomatic C1-2 disease from either primary or
secondary causes, we suggest against prophylactic interventional
therapies to prevent venous leg ulcer. (2-C)
