Mechanical Compression in the Prophylaxis of Venous Thromboembolism

Abstract

Venous thromboembolism (VTE) is an important cause of morbidity and mortality in a substantial number of the Australian community. There exists a considerable range of potential prophylactic measures aimed at reducing the risk of VTE. These antithrombotic regimens include pharmacological interventions and mechanical techniques to counteract venous stasis including graduated compression stockings and intermittent pneumatic compression (IPC) devices. This review particularly concentrates on evidence for the use of mechanical prophylaxis and the interrelationship with pharmacological methods of VTE prophylaxis. Mechanical and pharmacological methods of VTE prophylaxis are both effective and when used in combination have synergistic effects. Although there are a number of different IPC systems, little evidence is available at present that differentiates these on the basis of VTE prevention. Compliance and patient acceptance of IPC as a preventative measure has improved with miniaturization and device weight reduction. IPC should be used according to recommended guidelines. In moderate-risk patients when pharmacological prophylaxis is contraindicated, IPC can be used as an alternative. High-risk patients should receive both mechanical and pharmacological prophylaxis to reduce their relative risk. Until further evidence becomes available, the specific type of IPC unit chosen will generally be determined by ease of use, availability and cost.

Venous Thromboembolism: Classification, Risk Factors, Diagnosis, and Management

“…To prevent thrombus extension, decrease of the risk of recurrent thrombosis and subsequent death in patient with VTE pharmacological and/or mechanical approaches can be administered [8, 32, 33]. …”

Haemodynamic performance of neuromuscular electrical stimulation (NMES) during recovery from total hip arthroplasty

“…In addition to increasing mortality, DVT also prolongs hospitalisation which increases healthcare costs [2]. The valvular destruction associated with a dislodged thrombus leads to post-thrombotic chronic venous insufficiency in 30% of cases as well as venous ulceration and the risk of recurrent DVT [3,4]. The incidence rates of DVT remain unacceptably high with rates as high as 30% in general surgical patients and 85% in orthopaedic patients without prophylaxis [5-8].…”

Chronic venous disease progression and modification of predisposing factors

“…7,10,12,13 However, other potential factors that may be involved in CVD progression have not been well studied, such as estrogen treatment (ET), 10,11,14 and warrant further investigation. On the other hand, although many studies have shown that elastic compression stockings are the keystone of CVD treatment in the context of symptom relief, 15 ulcer healing, 16 and antithrombotic prophylaxis, 17 limited evidence is present on supportive role of elastic stocking use (ESU) in the inhibition of CVD progression that is limited mainly to patients with post-thrombotic etiology. 18 Although the advents of color duplex ultrasound (CDU) imaging and improvements in the classification of CVD 19 have significantly enhanced our current understanding of the underlying pathophysiology, studies on the natural history and progression of CVD are still scarce.…”