Ferid GOJAYEV, Birgün ÖZÇOLAK, Adil POLAT
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi - 2026;33(3):259-266
Objective To compare the clinical efficacy and patient adherence of knee-high versus thigh-high compression stockings, each combined with calcium dobesilate, versus pharmacologic therapy alone in the conservative management of chronic venous insufficiency (CVI). Material and Method This retrospective comparative cohort included 85 screened and 77 analyzed adults with duplex ultrasound-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) + dobesilate; 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 (phi = 0.55, p < 0.001). Compression adherence was ~90% for knee-high, ~22% for thigh-high users, and pharmacologic 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.
