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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2003 September;22(3):317-21

lingua: Inglese

Improved venous return by elliptical, sequential and seamless air-cell compression

Labropoulos N., Oh D. S., Golts E., Kang S. S., Mansour M. A., Baker W. H.

Depart­ment of Sur­gery, Loy­o­la Uni­ver­sity Med­i­cal Cen­ter, May­wood, IL, USA


Aim. The risk of deep vein throm­bo­sis (DVT) in the peri-oper­a­tive peri­od is sig­nif­i­cant, but can be ­reduced with the use of mechan­i­cal inter­mit­tent pneu­mat­ic com­pres­sion (IPC). These devic­es have ­reached wide­spread use in hos­pi­tals and have been found to be effec­tive pro­phy­lac­tic meas­ures ­against DVT. This study eval­u­ates the lat­est ­design fea­tures of one par­tic­u­lar IPC ­device in com­par­i­son to cur­rent mod­els.
Meth­ods. ­Duplex ultra­sound scan­ning was per­formed on 40 lower extrem­ities of 20 ­healthy vol­un­teers ­before and dur­ing the appli­ca­tion of the IPC ­device (Vena­Flow ­System, Air­cas, NJ, USA. Two hemo­dy­nam­ic param­e­ters were meas­ured, accel­er­a­tion time from spon­ta­ne­ous base­line ­venous flow and peak vein veloc­ity. All meas­ure­ments were ­obtained by scan­ning prox­i­mal to the saph­e­nof­e­mo­ral junc­tion in the com­mon femo­ral vein in both extrem­ities for each sub­ject. Data were ­obtained from 3 com­pres­sion ­cycles and aver­aged for each extrem­ity. ­Results were com­pared with a ­recent pros­pec­tive study form our cen­ter using a slow-fill­ing and a rapid-fill­ing sequen­tial IPC devic­es.
­Results. The ­medians for spon­ta­ne­ous aver­age peak veloc­ities at rest of the right and left lower extrem­ities were 26 cm/s and 24.1 cm/s. The ­median aug­ment­ed peak veloc­ities dur­ing the com­pres­sion cycle of the ­device in the right and left side were 79.6 cm/s and 79.0 cm/s. This rep­re­sent­ed a 306.2% ­increase in aver­age peak veloc­ity on the right side and a 327.8% ­increase on the left side. The ­median accel­er­a­tion time was 305 ms±40 in the left and 310 ms±50 in the right limb. There was no sta­tis­ti­cal­ly sig­nif­i­cant dif­fer­ence in the spon­ta­ne­ous and aug­ment­ed veloc­ities ­between the right and left lower extrem­ities in each sub­ject. In com­par­i­son to exist­ing slow- and rapid-fill­ing IPC devic­es the Vena­Flow ­System had super­i­or peak veloc­ities and short­er accel­er­a­tion times.
Con­clu­sion. The use of ellip­ti­cal, sequen­tial and rapid-fill­ing com­pres­sion of the leg with over­lap­ping air-cells pro­duc­es sig­nif­i­cant hemo­dy­nam­ic chang­es in the com­mon femo­ral vein, which are super­i­or to other sequen­tial slow- or rapid-fill­ing IPC devic­es. Ran­dom­ized stud­ies ­should be per­formed to deter­mine the effi­ca­cy of this new ­device in DVT pre­ven­tion.

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