Compression stockings attenuate the expression of proteins associated with vascular damage in human varicose veins

J Vasc Surg Venous Lymphat Disord . 2021 Mar;9(2):428-434. doi: 10.1016/j.jvsv.2020.05.020. Epub 2020 Jul 15.

Fecha de la publicación: 15/07/2020

Autor: Guillermo Moñux (1), Mariano de la Serna-Soto (2), Ferrán Plá-Sanchez (3), José J Zamorano-León (4), Antonio Segura (5), Rodrigo Rial (1), Gala Freixer (2), Khaoula Zekri-Nechar (2), Carlos Hugo-Martínez (2), Javier Serrano (3), Antonio López-Farré (6)

Palabras clave: Compression stocking, Endothelium, Inflammation, Thrombosis, Varicose veins



1Department of Angiology and Vascular Surgery, Hospital Universitario HM Torrelodones, Madrid, Spain.

2Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain.

3Vascular Surgery Department, Hospital Clínico San Carlos, Madrid, Spain.

4Department of Public Health and Maternal and Child Health, School of Medicine, Universidad Complutense, Madrid, Spain.

5Health Science Institute, Talavera de la Reina, Toledo, Spain.

6Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain. Electronic address:


Objective: The objective of this study was to analyze whether compression stocking therapy in the human varicose vein wall may change the levels of biomarkers associated with vein insufficiency.

Methods: Dilated collateral varicose vein samples were obtained from patients showing chronic venous disease (class 2 of the Clinical, Etiology, Anatomy, and Pathophysiology classification). Before elective surgery, 12 patients underwent compression stocking therapy (for 1 month) and 9 patients did not (control group). Expression levels of biomarkers associated with endothelial functionality (nitric oxide synthase 3), inflammation (interleukin-6, interleukin-10), oxidative stress (Gp91phox subunit of NADPH oxidase), and coagulation (factor Xa) were determined. P-selectin, an inflammatory and thrombosis-related biomarker, was also measured.

Results: Compression stockings increased the content of nitric oxide synthase 3 (control, 16.48 [16.04-17.40] AU; compression, 83.71 [67.70-91.85] AU; P < .001) in the varicose vein wall that was accompanied by reduction of both interleukin-6 levels (control, 38.72 [33.48-48.52] pg/μg protein; compression, 14.49 [11.05-17.41] pg/μg protein; P = .001) and the expression of Gp91phox subunit of NADPH oxidase (control, 63.24 [53.79-77.03] AU; compression, 36.85 [35.66-52.27] AU; P < .010). P-selectin (control, 77.37 [61.86-85.00] AU; compression, 54.31 [49.60-67.50] AU; P = .017) and factor Xa (control, 90.78 [75.02-100.00] AU; compression, 14.50 [13.77-36.20] AU; P < .001) were also reduced in the varicose vein wall of compression stocking-treated patients. However, P-selectin lost its statistical significance after adjustment by dyslipidemia.

Conclusions: In the varicose vein wall, compression stocking therapy improved the content levels of biomarkers associated with endothelial functionality, inflammation, oxidative stress, and coagulation.