1. A new study evaluated a compression device consisting of two thigh-level compression stockings and an interposed foam pad to increase interface pressures and reduce the diameter of the great saphenous vein. 2. The study measured interface pressures with and without the pad both standing and supine in 10 healthy subjects, finding pressures increased by 55% with the pad. 3. A CT scan with 3D reconstruction confirmed the pad reduced the diameter of the great saphenous vein by over 50% when used between two thigh compression stockings.

1. A new compression device for increasing interface pressures at the thigh level P ressure measurements and assessment by a CT scan Jean-Patrick Benigni * ** Jean-François Uhl **, André Cornu-Thenard **. * HIA Bégin, 69 av. de Paris, F94163 St Mandé ** French University Group for Medical Compression Study, Université des Saints Pères, Paris V.

2. A new compression device Background Treatment of the great saphenous vein Stripping and/or phlebectomy UGS Endovenous procedures Thigh compression is little used No consensus Laplace’s law Compression stocking or bandage : low pressures

3. A new compression device Background Nevertheless there are situations when thigh compression can be useful : prevention of deep venous thrombosis, relief of pain after surgery, endovenous procedures or sclerotherapy of the GSV, prevention of recanalisation.

4. A new compression device Background Prevention of side effects Direct and efficient compression on the thigh Use of a pad between the compression and the skin

5. A new compression device Objectives To measure the interface pressures point B1 point F 1 CS 2 CS With a special pad and without pad Standing and supine position

6. A new compression device Objectives To evaluate the effects by CT scan with 3D reconstruction on the GSV trunk of the superimposition of 2 thigh CS before and after adding the pad.

7. A new compression device Materials and method Kikuhime device Mediven Struva thigh CS ( Point B 23 mm Hg in vitro )

8. A new compression device Material and methods Foam pad Hard foam core Peripheral softer foam 29 mm thick and 70 mm wide Mediven Post Op Pad

9. Material and methods 10 healthy subjects 6 measurements Standing and supine 3 times 360 measurements A new compression device

10. A new compression device Results Description of the population 6 females and 4 males 41.7+/-17.4 years old Height 166.5+/-7.3 cm Weight 61.1+/-8.4 kg Circumference at point B1 22+/- 1.8 cm Circumference at point F 50 +/-3.4 cm

11. A new compression device 1 CS 2CS Without pad ankle With pad 1 CS 2CS 19 mmHg 33 mmHg 11.5 mmHg 19 mmHg 36.5 mmHg 57.5 mmHg Supine position

12. A new compression device 1 CS 2CS Without pad ankle With pad 1 CS 2CS 23 42 12 22 43 mm Hg 66 mm Hg Standing position

13. A new compression device Results - 55 %

14. A new compression device Conclusion The interposition of a specific pad between 2CS and the skin can be used to increase the interface pressures A CT scan with 3D reconstruction confirms that the interposition of a specific foam pad produces a reduction of caliber of the GSV of over 50% under 2 CS.

16. That's all folks !