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Online ISSN 1827-1847
Bernardo B. 1, Bruno A. 1, Capasso R. 1, Coppola G. 1, Pozza M. 1, Raucci A. 1, Della Guardia G. 2, Dell’Anno B. 2, Perrotta A. 2
1 Section of Vascular and Endovascular Surgery Villa del Sole Clinic, Caserta, Italy
2 Section of Anesthesia and Resuscitation Villa del Sole Clinic, Caserta, Italy
Venous thromboembolism (VTE), a major cause of death and mortality in hospitalized patients, may be largely prevented with adequate prophylaxis. Although low-molecular-weight heparin (LMWH) reduces by more than 50% the incidence of deep venous thrombosis DVT) with minimal bleeding, the disease still occurs in over 20% of total hip and knee replacement patients. Sequential pneumatic compression (SPC) is an attractive method of mechanical prophylaxis that does not increase the risk of bleeding. Two advantages to SPC are that it prevents venous stasis and enhances fibrinolytic activity. Investigators studying the effect of SPC on venous haemodynamics have reported a significant increase (P<0.001) in peak flow velocity, mean velocity, flow volume and pulsatility index. The best results can be obtained with calf+foot systems. SPC associated with LMWH or alone in the prevention of DVT is recommended in moderate-risk general or urological surgery patients and in high-risk patients undergoing total hip or knee replacement or elective neurosurgery.