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Intermittent pneumatic compression (IPC) consistently prevents venous stasis by increasing venous return of the legs but fails to prevent deep vein thrombosis (DVT) in some patients, especially patients with malignancy and subarachnoid haemorrhage (SAH). This suggests a mechanism in addition to preventing stasis is required for the prophylactic effect of IPC. IPC increases fibrinolysis and this may contribute to DVT prevention. In 74 patients with SAH treated with anti fibrinolytic drugs, 21% of 42 randomized to IPC prophylaxis developed DVT and 19% of 32 controls. In 143 neurosurgical patients aged &gt;55 years and not treated with antifibrinolytic drugs, 30% of controls (n=76) developed DVT compared to 16% treated with IPC (n=67; p&gt;0.05), in contrast to 187 patients  55, there was no difference in lysis time in IPC patients compared with age-matched controls (10.2 ± 1.4 v 9.7 ± 0.8; p&gt; 0.1). In all patients treated with antifibrinolytic drugs, lysis times were markedly prolonged. The data show that ineffectiveness of IPC in certain patient groups was related to failure of enhancement of fibrinolytic activity and this is consistent with the hypothesis that activation of fibrinolysis contributes to the prevention of DVT with IPC.

The Contribution Of Increased Fibrinolysis Induced By Intermittent Pneumatic Compression Of The Legs In The Prevention Of Deep Vein Thrombosis