A review of compression therapy, effect, characteristics, and theories for chronic venous insufficiency

Introduction
Compression therapy is an efficient technique in managing Chronic Venous Insufficiency (CVI) to help blood return. Despite its widespread clinical use, biomechanical properties, and mathematical models remain underexplored in a cohesive framework that offers evidence of how compression therapy works.
Objectives
This review aims to guide the development of next-generation compression systems, by synthesizing insights from underlying compression mechanisms and biomechanical theories.
Methods
A literature review was conducted using Scopus, search terms including CVI, compression, etc., encompassing articles from 1990 to 2025 with inclusion and exclusion criteria focused on three domains: biomechanical tissue properties, compression levels to treat CVI, theoretical models relating interface pressure to functional compression.
Results
Forty studies met the criteria: 28 addressed effects and characteristics, and 12 proposed theoretical models. Applied compression to the tissue induces an increase in overall stiffness and reduces venous diameters to restore impaired venous valves. Different parameter combinations, which depend on clinical stages, affected tissue (superficial or deep vein), and body positions (standing or supine), were identified as design requirements, including pressure type (static or dynamic), pressure value, and distribution (graduated or progressive). One theoretical model highlights interface pressure modeling in the design process.
Conclusion
Personalized therapy for optimal management of CVI is challenging in current solutions. The dynamic compression systems hold promise for accommodating individual variability in muscle stiffness—a critical factor influencing the transmission of external pressure to venous veins. Such systems can modulate pressure in real-time, ensuring optimal pressure under various body positions and adapting to symptom progression over extended periods.