[New method of preventing thrombosis: Intermittent sequential high-pressure leg compression (author's transl)]

Area of Science:

• Vascular Surgery
• Medical Devices
• Thrombosis Prevention

Background:

• Postoperative thrombosis remains a significant clinical concern, particularly in immobile patients.
• Sequential pneumatic compression (SPC) is a non-invasive method to enhance venous return.
• Optimal pressure settings for SPC efficacy in preventing thrombosis are not fully established.

Purpose of the Study:

• To evaluate the effect of different pressures of sequential pneumatic leg compression on venous flow velocity.
• To compare the incidence of postoperative thrombosis with varying SPC pressures and heparin prophylaxis.
• To establish recommendations for SPC use in high-risk patients.

Main Methods:

• Twenty-five patients were assessed for changes in venous flow velocity under SPC at 35-55 mm Hg and 90-100 mm Hg.
• Three groups of patients were studied for postoperative thrombosis incidence: high-pressure SPC (90-100 mm Hg), low-pressure SPC (35 mm Hg), and heparin prophylaxis.
• SPC involved ten compression cycles, three times daily.

Main Results:

• Venous flow velocity increased to 175% of control at 35-55 mm Hg and significantly to 366% at 90-100 mm Hg.
• Postoperative thrombosis occurred in one of 24 patients with high-pressure SPC, compared to three in 25 patients with low-pressure SPC and three in 25 patients receiving heparin.
• High-pressure SPC demonstrated a trend towards lower thrombosis incidence than low-pressure SPC or heparin.

Conclusions:

• High-pressure sequential pneumatic leg compression (90-100 mm Hg) is more effective in increasing venous flow velocity than lower pressures.
• High-pressure SPC shows promise in reducing postoperative thrombosis incidence, especially in patients with contraindications to anticoagulants or those unable to mobilize.
• Sequential pneumatic compression should be used adjunctively with antithrombosis stockings.