Other options for venous thromboembolism prevention
Although mechanical prophylaxis
methods have been shown to reduce the risk of DVT, they have been studied much less intensively than the major pharmacological treatment options:3
- Mechanical methods of prophylaxis include graduated compression stockings and various intermittent compression devices, all of which increase venous outflow or reduce stasis within the leg veins
- Graduated compression stockings have been shown to effectively reduce symptomatic DVT; however, their use is also associated with an increase in skin complications293
- Mechanical prophylaxis should be used primarily in patients who are at high risk of bleeding, or as an adjunct to anticoagulant therapy
Mechanical methods for VTE prophylaxis
|Graduated compression stockings
||Provide circumferential pressure that gradually decreases from the ankle to the thigh to promote venous blood flow
||Studies in hip surgery,114 general surgery115 and stroke180
|Intermittent pneumatic compression
||Leggings repeatedly inflated and deflated by a pneumatic pump with the goal of mimicking natural calf muscle contractions that promote venous return
||Analysis of seven hip fracture studies115
|Venous foot pump
||Imitate the physiological pumping action of weight-bearing on the venous plexus of the sole of the foot to simulate the effect of normal walking and increase venous flow
- 3 - Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6)(suppl):381S-453S.
- 293 - Falck-Ytter Y, Francis CW, Johanson NA et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012;141:e278S–e325S.
- 114 - Cohen AT, Skinner JA, Warwick D, Brenkel I. The use of graduated compression stockings in association with fondaparinux in surgery of the hip. A multicentre, multinational, randomised, open-label, parallel-group comparative study. J Bone Joint Surg Br. 2007;89(7):887-892.
- 115 - Agnelli G. Prevention of venous thromboembolism in surgical patients. Circulation.2004;110(24)(suppl 1):IV4-IV12.
- 180 - Dennis M, Sandercock PA, Reid J, et al; CLOTS Trials Collaboration. Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial. Lancet. 2009;373(9679):1958-1965.
- The prevention of a disease or pathological condition.