Intermittent pneumatic foot compression can activate blood fibrinolysis without changes in blood coagulability and...

Area of Science:

• Vascular Surgery
• Thrombosis Research
• Biomedical Engineering

Background:

• Intermittent pneumatic foot compression (IPC) is a standard prophylaxis for peri-operative venous thromboembolism.
• Understanding IPC's precise effects on hemostasis is crucial for optimizing its clinical application.
• This study investigates IPC's impact on blood coagulation, fibrinolysis, and platelet function.

Purpose of the Study:

• To evaluate the effect of intermittent pneumatic foot compression (IPC) on blood coagulation and fibrinolysis.
• To assess IPC's influence on platelet function.
• To measure serum levels of key hemostatic markers including tissue-type plasminogen activator (t-PA), thrombomodulin (TM), and activated protein C (APC).

Main Methods:

• Eight subjects underwent 60-minute IPC (130 mmHg, 0.3 Hz interval).
• Blood coagulation and fibrinolysis were assessed using a Sonoclot whole blood analyzer.
• Platelet function was measured with a platelet aggregation monitor (WBA analyzer™), alongside serum t-PA, TM, and APC levels.

Main Results:

• IPC significantly shortened Sonoclot time-to-peak and increased clot retraction rate, indicating enhanced fibrinolysis.
• Platelet aggregatory threshold index (PATI) remained unchanged, showing no direct activation of platelet function by IPC.
• Serum t-PA concentration decreased significantly, suggesting a mechanism for fibrinolytic activation; other humoral parameters were unaffected.

Conclusions:

• IPC effectively activates blood fibrinolysis, contributing to its prophylactic role against thromboembolism.
• The mechanism involves enhanced fibrinolytic activity, potentially via t-PA function modulation, rather than direct effects on coagulation or platelet aggregation.
• IPC is beneficial for thromboembolism prophylaxis by promoting fibrinolysis and inhibiting blood stasis.