Contents

Search

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; chronic venous insufficiency

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