Feasibility of intermittent pneumatic compression for venous thromboembolism prophylaxis during magnetic resonance...

Venous thromboembolism (VTE) is a common cause of morbidity and mortality in hospitalized and surgical patients. To reduce risk, perioperative VTE prophylaxis is recommended for cancer patients undergoing surgical or interventional procedures. Magnetic resonance imaging (MRI) is increasingly used in interventional oncology when alternative imaging modalities do not adequately delineate malignancies. Extended periods of immobilization during MRI-guided interventions necessitate an MR compatible sequential compression device (SCD) for intra-procedural mechanical VTE prophylaxis. Such devices are not commercially available.

A standard SCD routinely used at our institution for VTE prophylaxis during interventional procedures was used. To satisfy MR safety requirements, the SCD controller was placed in the MR control room and connected to the compression sleeves in the magnet room through the wave guide using tubing extensions. The controller pressure sensor was used to monitor adequate pressure delivery and detect ineffective low or abnormal high pressure delivery. VTE prophylaxis was provided using the above mentioned device for 38 patients undergoing MR-guided ablations.

There was no evidence of device failure due to loss of pressure in the extension tubing assembly. No interference with the anesthesia or interventional procedures was documented.

Although the controller of a standard SCD is labeled as "MR-unsafe", the SCD can be used in interventional MR settings by placing the device outside the MR scanner room. Using serial tubing extensions did not cause device failure. The described method can be used to provide perioperative mechanical VTE prophylaxis for high risk patients undergoing MR-guided procedures.