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International Angiology 2003 September;22(3):317-21


language: English

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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