A portable pneumatic compression device to prevent venous thromboembolism in orthopedic patients with the highest risks of both venous thrombosis and bleeding: A case series study

Abstract

Purpose: There is a pressing need for safe venous thromboembolism (VTE) prophylaxis in orthopedic patients with the highest risks of both venous thrombosis and bleeding. Portable intermittent pneumatic compression device (IPCD) has proven to be effective and safe in patients with a high risk of venous thrombosis and low bleeding risk. Therefore, this study examined the effectiveness, safety, and wearing compliance of portable IPCD for postoperative VTE prophylaxis in patients with the highest risks of both venous thrombosis and bleeding. Methods: The cases consisted of 38 patients who had used a portable IPCD and had the highest risks of both venous thrombosis and bleeding. We examined the incidence of VTE to assess the effectiveness of the portable IPCD, the presence of hemorrhagic adverse events to assess safety, and the wearing rate to assess wearing compliance. Results: The incidences of asymptomatic and symptomatic deep vein thrombosis were 5.3% and 2.6%, respectively. The incidence of hemorrhagic adverse events was 21.1% in patients who received anticoagulants and wore an IPCD simultaneously and 0% in patients who wore an IPCD but did not receive anticoagulants. The wearing rate (i.e. ≥18 h/day) was 100%. Conclusion: Portable IPCD has the potential for safe VTE prophylaxis in patients at high risks for both venous thrombosis and bleeding. Therefore, we suggest that such patients use a portable IPCD for VTE prophylaxis.

Preoperative incidence and risk factors of deep vein thrombosis in patients with an isolated patellar fracture

“…lower limb elevation and deep breath) and chemoprophylaxis (subcutaneous injection of low molecular weight heparin, 2500-4100 IU, once daily). All patients routinely received Intermittent Pneumatic Compression Devices(IPCD)to prevent thrombosis [ 14 , 15 ]. For patients allergic to LMWH, oral rivaroxaban was administered at a dosage of 10 mg once daily.…”

Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 3. Pharmacological venous thromboembolism prophylaxis

“…In a case series of 38 patients who underwent lower extremity orthopedic surgery with the highest risk of both venous thrombosis and bleeding, a portable pneumatic compression device was used to prevent VTE [ 44 ]. The results showed that the incidence of asymptomatic DVT was 5.3%, and that of symptomatic DVT was 2.6% [ 44 ]. No major bleeding or adverse events were observed [ 44 ].…”

“…The results showed that the incidence of asymptomatic DVT was 5.3%, and that of symptomatic DVT was 2.6% [ 44 ]. No major bleeding or adverse events were observed [ 44 ]. Also, a retrospective study reviewed all patients with hemophilia A or B who underwent primary TKA and THA using a mechanical prophylaxis without chemoprophylaxis [ 45 ].…”

Venous thromboembolism risk factors and usefulness of a risk scoring system in lower limb orthopedic surgery

“…The CCDSS is a decision-making system that works in 3 steps. [ 20 ] First, the VTE risk level in each type of surgery is categorized. Second, the system automatically adds the risk score for 16 additional VTE risk factors (eg, background factors and patient history) to determine the VTE risk level, and the risk factors are listed with weights of −2 to 8 points each.…”