Efficacy of complex decongestive therapy on venous flow, internal saphenous diameter, edema, fat mass of the limbs and quality of life in patients with chronic venous insufficiency: A randomized clinical trial

J Vasc Surg Venous Lymphat Disord. 2025 Mar;13(2):102005. doi: 10.1016/j.jvsv.2024.102005. Epub 2024 Nov 13.

Abstract

Objective: Demonstrate the effectiveness of complex decongestive therapy (CDT) in patients with chronic venous insufficiency (CVI).

Methods: A single-blind randomized controlled trial was conducted, where the participants were patients with CVI (n = 21/42) were assigned randomly to an experimental group (n = 11/22) or a control group (n = 9/18). A treatment of CDT (manual lymphatic drainage, intermittent pneumatic presotherapy, bilayer bandage) was applied to the experimental group for 4 weeks 2 days per week and no treatment was applied to the control group. The patients were evaluated at baseline (t0), 1 week after finishing the intervention (t1), and 6 weeks after the intervention (t2). The effectiveness of the treatment on symptoms and quality of life (QoL) (heaviness, pain and Chronic Venous Insufficiency Quality of Life [CIVIQ-20] questionary), edema, venous flow, and impedanciometry measurements was evaluated.

Results: An improvement in the patient's QoL was observed: there was a decrease in symptoms such as heaviness and pain, an increase in the average velocity of the left femoral vein and left internal saphenous vein (ISV), a decrease in the ISV diameter in both extremities and a decrease in body mass index and fat mass in both extremities. These results were maintained when following up at 6 weeks, except for the improvement of QoL.

Conclusions: CDT treatment improves the CIVIQ-20 and Venous Clinical Severity Scores. It also improves symptoms (pain and heaviness), venous flow velocity (superficial veins and deep veins [common femoral vein, femoral vein, popliteal vein]) and decreases body mass index, fat mass, and ISV diameter.

Keywords: Chronic venous insufficiency; Complex decongestive therapy; Edema; Impedanciometry; Manual lymphatic drainage; Multilayer bandage; Physiotherapy; Quality of life; Venous flow.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adiposity*
  • Adult
  • Aged
  • Chronic Disease
  • Edema* / diagnosis
  • Edema* / etiology
  • Edema* / physiopathology
  • Edema* / therapy
  • Female
  • Humans
  • Intermittent Pneumatic Compression Devices*
  • Male
  • Manual Lymphatic Drainage* / adverse effects
  • Middle Aged
  • Quality of Life*
  • Regional Blood Flow
  • Saphenous Vein* / diagnostic imaging
  • Saphenous Vein* / physiopathology
  • Single-Blind Method
  • Time Factors
  • Treatment Outcome
  • Venous Insufficiency* / complications
  • Venous Insufficiency* / diagnosis
  • Venous Insufficiency* / diagnostic imaging
  • Venous Insufficiency* / physiopathology
  • Venous Insufficiency* / therapy