Venous thromboembolic disease reduction with a portable pneumatic compression device.

This study compares a miniaturized, portable, sequential, pneumatic compression device (ActiveCare continuous enhanced circulation therapy [CECT] system) (Medical Compression Systems Ltd, Or Aqiva, Israel), with a nonmobile, nonsequential device on the ability to prevent postoperative deep venous thrombosis (DVT) after joint arthroplasty. All patients were treated with low-molecular-weight heparin, application of 1 of the 2 devices perioperatively, and routine duplex screening. The CECT system had better compliance (83% of the time vs 49%), lower rates of DVT (1.3% compared with 3.6%), reduction in clinically important pulmonary embolism (0 compared to 0.66%), and shorter length of hospital stay (4.2 vs. 5.0 days). The portable CECT system proved significantly more effective than the standard intermittent pneumatic compression when used in conjunction with low-molecular-weight heparin for DVT prevention in high-risk orthopedic patients.

[1]  A. Salvator,et al.  Hemodynamic and fibrinolytic consequences of intermittent pneumatic compression: preliminary results. , 1996, The Journal of trauma.

[2]  J. Heit,et al.  Prevention of venous thromboembolism. , 2001, Clinics in geriatric medicine.

[3]  R. Lifeso,et al.  Intermittent pneumatic compression versus coumadin. Prevention of deep vein thrombosis in lower-extremity total joint arthroplasty. , 1991, Clinical orthopaedics and related research.

[4]  R. Brand,et al.  Venous thromboembolic disease management patterns in total hip arthroplasty and total knee arthroplasty patients: a survey of the AAHKS membership. , 2001, The Journal of arthroplasty.

[5]  R. Dawson,et al.  EFFECT OF INTERMITTENT COMPRESSION OF THE ARMS ON DEEP VENOUS THROMBOSIS IN THE LEGS , 1976, The Lancet.

[6]  K. Campbell,et al.  Compliance with Sequential Compression Device Prophylaxis in At-Risk Trauma Patients: A Prospective Analysis , 2002, The American surgeon.

[7]  G. Hunter,et al.  Deep venous thrombosis prophylaxis in trauma: improved compliance with a novel miniaturized pneumatic compression device. , 2003, Journal of vascular surgery.

[8]  E. Hachulla,et al.  Cannabis Arteritis Revisited , 2001, Angiology.

[9]  A. Comerota,et al.  Why does prophylaxis with external pneumatic compression for deep vein thrombosis fail? , 1992, American journal of surgery.

[10]  J. Hosking,et al.  The fibrinolytic effects of intermittent pneumatic compression: mechanism of enhanced fibrinolysis. , 1997, Annals of surgery.

[11]  A. Nicolaides,et al.  Prevention and treatment of venous thromboembolism - International Consensus Statement (Guidelines according to scientific evidence) , 2006 .

[12]  G. Guyatt,et al.  The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy , 2004 .

[13]  John P. Woodcock,et al.  Evidence-Based Compression: Prevention of Stasis and Deep Vein Thrombosis , 2004, Annals of surgery.

[14]  A. Nicolaides.  Prevention of Venous Thromboembolism: International Consensus Statement , 1997 .

[15]  G. Raskob,et al.  Prophylaxis of venous thromboembolic disease following hip and knee surgery. , 1986, The Journal of bone and joint surgery. American volume.

[16]  J. Woodcock,et al.  Systemic haemostasis after intermittent pneumatic compression. Clues for the investigation of DVT prophylaxis and travellers thrombosis. , 2004, Clinical and laboratory haematology.

[17]  S. Kelley,et al.  Two mechanical devices for prophylaxis of thromboembolism after total knee arthroplasty. A prospective, randomised study. , 2004, The Journal of bone and joint surgery. British volume.

[18]  G. Oster,et al.  Cost of venous thromboembolism following major orthopedic surgery in hospitalized patients. , 2002, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[19]  F. Haddad,et al.  Unanticipated variations between expected and delivered pneumatic compression therapy after elective hip surgery: a possible source of variation in reported patient outcomes. , 2001, The Journal of arthroplasty.

[20]  A. Nicolaides,et al.  Prevention of venous thromboembolism. International Consensus Statement. Guidelines compiled in accordance with the scientific evidence. , 2001, International angiology : a journal of the International Union of Angiology.

[21]  Clifford W Colwell,et al.  Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. , 2004, Chest.

[22]  H. Potter,et al.  Recent advances in venous thromboembolic prophylaxis during and after total hip replacement. , 2000, The Journal of bone and joint surgery. American volume.

[23]  T. Sculco,et al.  Prophylaxis against Deep Venous Thrombosis after Total Knee Arthroplasty. Pneumatic Plantar Compression and Aspirin Compared with Aspirin Alone* , 1996, The Journal of bone and joint surgery. American volume.

[24]  J. Bradley,et al.  The effectiveness of intermittent plantar venous compression in prevention of deep venous thrombosis after total hip arthroplasty. , 1993, The Journal of arthroplasty.

[25]  R. Coleman,et al.  Prevention of Postoperative Venous Thromboembolism by External Pneumatic Calf Compression in Patients With Gynecologic Malignancy , 1984, Obstetrics and gynecology.