Compression Therapy Grades for Venous Disease
For venous disease, compression therapy is classified into distinct pressure grades: 20-30 mm Hg for mild to moderate disease and 30-40 mm Hg for severe disease, with these specific pressure ranges representing the standard classification system used in clinical practice. 1
Standard Compression Grades
The compression therapy classification system is based on pressure levels measured in millimeters of mercury (mm Hg):
Low-Level Compression (10-30 mm Hg)
- Effective for: telangiectases after sclerotherapy, varicose veins in pregnancy, prevention of edema and deep vein thrombosis 2
- Typical range: 20-30 mm Hg is the minimum recommended pressure for basic compression therapy in chronic venous disease 1
Moderate Compression (20-30 mm Hg)
- Primary indication: mild to moderate venous disease 1
- Safe for arterial compromise: patients with ankle-brachial indices between 0.9 and 0.6 can safely use this compression level for venous leg ulcer healing 1
- Note: This pressure range effectively compresses veins when patients are supine but may not compress leg veins adequately in the standing position 3
High-Level Compression (30-40 mm Hg)
- Primary indications: severe venous disease manifestations, venous leg ulcers, post-thrombotic syndrome prevention, and lymphedema management 1, 2
- Superior efficacy: inelastic compression at 30-40 mm Hg is more effective than elastic bandaging for venous leg ulcer healing 1
- Optimal pressure threshold: there appears to be an upper limit around 50-60 mm Hg for the lower extremity, beyond which further pressure increases become counterproductive 4
Critical Safety Considerations
Contraindication threshold: When ankle-brachial index is <0.6, this indicates significant arterial disease requiring revascularization before aggressive compression therapy can be safely applied 1
Common Pitfall
The major limitation of compression therapy is poor patient compliance 5. Treatment failure typically results from non-compliance rather than ineffective pressure levels, making proper fitting, patient education, and detailed instructions essential for therapeutic success 1.