A venous foot pump reduces thrombosis after total hip replacement

Abstract

In a prospective, randomised controlled trial, the efficacy of the A-V Impulse System in the prevention of deep-vein thrombosis was investigated in 84 patients who had undergone total hip replacement. The incidence of venographically proven, and clinically significant postoperative deep-vein thrombosis was 40% in the control group and 5% in the treatment group (p less than 0.001). No adverse reactions were recorded.

Natural Course of Asymptomatic Deep Venous Thrombosis in Hip Surgery without Pharmacologic Thromboprophylaxis in an Asian Population

“…Our data show there is a low incidence of DVT associated with the use of mechanical prophylaxis for patients undergoing elective hip surgeries, and we confirmed the results of others who reported low incidences of DVT and PE using mechanical thromboprophylaxis with IPC with or without aspirin for patients having elective hip surgery (Table 2) [4,6,12,19,26,28,29,33,34]. Moreover, none of our patients had proximal DVTs, none had fatal or symptomatic PEs, and the 6-month postoperative mortality was 0%.…”

“…Several guidelines for DVT and PE prevention have recommended anticoagulant drugs based on studies showing efficacy for reducing the incidence of DVT, including asymptomatic DVT [8,23,32]. However, mechanical thromboprophylaxis with IPC has been used for almost 20 years [19] and reportedly also has been effective as prophylaxis against DVT and PE when used in combination with other nonpharmacologic modalities with or without aspirin [4,6,12,19,26,28,29,33,34]. As IPC might be contraindicated with preoperative DVT, it is important to know the incidence of preoperative asymptomatic DVT when considering IPC for DVT and PE prophylaxis.…”

“…Several guidelines for DVT and PE prevention have recommended anticoagulant drugs based on studies showing efficacy for reducing the incidence of DVT, including asymptomatic DVT, using imaging modalities [8,13,23,32]. However, mechanical prophylaxis with intermittent pneumatic compression (IPC) in combination with other nonpharmacologic modalities such as regional anesthesia, rapid mobilization, and/or aspirin also reportedly is effective for thromboprophylaxis with 0.7% to 5.3% incidences of DVT [4,6,12,19,26,28,29,33,34]. A previous multicenter study of 3016 patients who underwent elective hip surgeries and received IPC prophylaxis without pharmacologic agents showed no patients had fatal postoperative PE, one (0.03%) had a symptomatic PE, and four (0.1%) had symptomatic DVT [31].…”

Foot pump prophylaxis for deep venous thrombosis?rate of effective usage following knee and hip arthroplasty

“…They also cause local activation of the fibrinolytic system [8,12]. They have been shown in prospective randomised control trials to be as equally effective in DVT prophylaxis as low-molecular-weight heparin and heparin following total knee and hip replacement [2,3,6,13]. They have also been shown to be as equally effective as anticoagulant agents in trauma patients [10,11].…”

The Anatomy and Physiology of the Venous Foot Pump

“…The subsequent development of intermittent pneumatic compression devices, which activate the foot pump by compression of the plantar venous plexus, had a reported significant impact on the prevention of asymptomatic deep vein thrombosis (DVT) (Fordyce and Ling, 1992;Wilson et al, 1992;Santori et al, 1994;Westrich and Sculco, 1996;Warwick et al, 1998;Urbankova et al, 2005). In addition, the use of neuromuscular electrical stimulation of the foot and leg has been assessed for DVT prevention and the treatment of venous disease (Laverick et al, 1990;Faghri et al, 1998;Clarke Moloney et al, 2006).…”