Comparison of Clinical and Physiological Efficacies of Different Intermittent Sequential Pneumatic Compression Devices in Preventing Deep Vein Thrombosis: A Prospective Randomized Study

Abstract

BackgroundThere are few comparative studies about the optimal method of pneumatic compression to prevent deep vein thrombosis (DVT). The aim of this prospective randomized study was to compare venous hemodynamic changes and their clinical influences between two graded sequential compression groups (an alternate sequential compression device [ASCD] vs. a simultaneous sequential compression device [SSCD]).MethodsIn total, 34 patients (68 limbs) undergoing knee and spine operations were prospectively randomized into two device groups (ASCD vs. SSCD groups). Duplex ultrasonography examinations were performed on the 4th and 7th postoperative days for the detection of DVT and the evaluation of venous hemodynamics. Continuous data for the two groups were analyzed using a two-tailed, unpaired t-test. Relative frequencies of unpaired samples were compared using Fisher exact test. Mixed effects models that might be viewed as ANCOVA models were also considered.ResultsDVT developed in 7 patients (20.6%), all of whom were asymptomatic for isolated calf DVTs. Two of these patients were from the ASCD group (11.8%) and the other five were from the SSCD group (29.4%), but there was no significant difference (p = 0.331). Baseline peak velocity, mean velocity, peak volume flow, and total volume flow were enhanced significantly in both device groups (p < 0.001). However, the degrees of flow and velocity enhancement did not differ significantly between the groups. The accumulated expelled volumes for an hour were in favor of the ASCD group.ConclusionsBoth graded sequential compression devices showed similar results both in clinical and physiological efficacies. Further studies are required to investigate the optimal intermittent pneumatic compression method for enhanced hemodynamic efficacy and better thromboprophylaxis.

Prophylactic inferior vena cava filter placement prior to lumbar surgery in morbidly obese patients: Two-case study and literature review

“…Pneumatic CS alone reduce the incidence of DVT/PE in patients undergoing spinal surgery. [ 4 10 ] To reduce the risk of DVT/PE in lumbar surgery, Epstein promoted CS prophylaxis alone in 139 patients undergoing multilevel lumbar laminectomies (average 3.8 levels) and instrumented fusions (average 1.4 levels) [ Table 2 ]. [ 4 ] Low dose heparin (LDH) prophylaxis was not used to avoid the risk of postoperative hematoma/seroma and/or wound breakdown/dehiscence.…”

“…compared the relative efficacy of two types of sequential compression devices (SCD's) to avoid DVT in 34 patients (68 limbs) undergoing knee and spine operations [Tables 1 and 2 ]. [ 10 ] Patients recieved either ASCD vs. SCCD (variants of compression stockings). All were followed with routine lower extremity Doppler's performed on the 4 th and 7 th postoperative days.…”

Factors predicting venous thromboembolism after spine surgery

“…About half of all untreated DVT cases are complicated by PE, and, on the contrary, 50% to 80% of all untreated PE cases are related to DVT. [2,3] Attention must be paid on VTE for surgeons, and increasing studies reported on risk factors of VTE.…”

Prevalence and risk factors of deep vein thrombosis in patients after spine surgery: a retrospective case-cohort study

“…Most of the literature and international guidelines on VTE emphasize that prevention is more important and cost-effective than treatment, because once VTE develops, it can only be cured at considerable expense. Although approximately two-thirds of all VTE events result from hospitalization, only one-third of all hospitalized patients at risk receive adequate prophylactic treatment 10 . Currently, common prophylactic treatment mainly includes two types of therapies.…”