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intermittent pneumatic compression device (IPC); synchronized compression device (SCD)

Air-filled compression devices that provide compression on the calfs and thighs. Devices may be single chambered or sequential. Indications: 1) bed-ridden patients to prevent deep-vein thrombosis (DVT) often in connection with ted hose (TEDs) 2) treatment of venous stasis 3) intermittent arterial claudication [2] Benefit/risk: - number needed to treat to prevent one proximal DVT in immobile stroke patient = 23 [4] - no benefit in pneumatic compression added to LMW heparin in preventing DVT [5] Complications: - risk of skin injury < 3-4% [5] - no higher incidence of limb ischemia or limb amputation [4] Clinical trials: - better than graduated compression stockings for preventing deep vein thrombosis [3] - reduces incidence of deep vein thrombosis in immobile stroke patients [4] - does not prevent symptomatic proximal deep vein thrombosis, pulmonary embolism or death in immobile stroke patients [4] Notes: - cost $4800 (unilateral) [2] - thus cost to prevent 1 proximal DVT is at least $110,400 [2,4]

Related

deep vein thrombosis (DVT) pneumatic venous stasis; venous hypertension

Specific

pneumatic antishock garment (PASG)

General

device (medical device)

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  2. Journal Watch 25(8):63, 2005 Delis KT, Nicolaides AN. Effect of intermittent pneumatic compression of foot and calf on walking distance, hemodynamics, and quality of life in patients with arterial claudication: a prospective randomized controlled study with 1-year follow-up. Ann Surg. 2005 Mar;241(3):431-41. PMID: 15729065
  3. Morris RJ and Woodcock JP. Intermittent pneumatic compression or graduated compression stockings for deep vein thrombosis prophylaxis? A systematic review of direct clinical comparisons. Ann Surg 2010 Mar; 251:393. PMID: 20083996 - Caprini JA. Stockings or no stockings: That is the question. Ann Surg 2010 Mar; 251:397 PMID: 20083992
  4. CLOTS (Clots in Legs Or sTockings after Stroke) Trials Collaboration. Effectiveness of intermittent pneumatic compression in reduction of risk of deep vein thrombosis in patients who have had a stroke (CLOTS 3): A multicentre randomised controlled trial. Lancet 2013 May 31 PMID: 23727163 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61050-8/fulltext - ACP Journal Club Intermittent pneumatic compression reduced deep venous thrombosis after stroke Ann Intern Med. 2013;159(4):JC3. http://annals.org/article.aspx?articleid=1726858
  5. Rothaus C Pneumatic Compression for Venous Thromboprophylaxis. NEJM Resident 360. April 3, 2019 https://resident360.nejm.org/content_items/pneumatic-compression-for-venous-thromboprophylaxis