Comparative Efficacy of Knee-High Versus Thigh- High Compression Stockings in Managing Chronic Venous Insufficiency: A Retrospective Comparative Cohort Study

ObjectiveTo compare the clinical efficacy and patient adherenceof knee-high versus thigh-high compression stockings,each combined with calcium dobesilate, versus pharmacologictherapy alone in the conservative managementof chronic venous insufficiency (CVI).Material and MethodThis retrospective comparative cohort included 85screened and 77 analyzed adults with duplex ultrasound–confirmed CVI (CEAP C1–C5) treated at asingle tertiary center (January–June 2023). Patientsreceived: (Group 1) knee-high stockings (EuropeanClass II, 23–32 mmHg) + calcium dobesilate 500 mgbid; (Group 2) thigh-high stockings (Class II) + dobesilate;or (Group 3) dobesilate alone. Each compressionpatient was provided two pairs and instructed for dailywear for≥3 months. Adherence (≥80% of prescribeddays/doses) was assessed via diaries, monthly calls,in-clinic inspection (compression), and pill counts/self-report (drug). Disease severity was evaluatedby Venous Clinical Severity Score (VCSS) at 3 and 6months. Non-parametric tests with effect sizes wereused.ResultsAmong 77 analyzed patients, Group 1 (knee-high +dobesilate) achieved the greatest improvement, withmedian 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 (φ =0.55, p < 0.001). Compression adherence was ~90%for knee-high, ~22% for thigh-high users, and pharmacologicadherence exceeded 85% in all groups. Nomajor adverse events or discontinuations occurred.ConclusionKnee-high stockings plus calcium dobesilate yieldedsuperior clinical improvement and adherence versusthigh-high stockings or pharmacologic therapy alone.Comfort and usability were key adherence drivers;knee-high Class II compression should be prioritizedin most CVI patients, with pharmacologic therapy as auseful adjunct, particularly in early stages.