Improved hemodynamic effectiveness and associated clinical correlations of a new intermittent pneumatic compression system in patients with chronic venous insufficiency (original) (raw)

2001, Journal of Vascular Surgery

modalities, the incidence of venous thromboembolism is still unacceptable in high-or very high-risk groups, as defined by means of clinical risk factors, necessitating an individual protective strategy. 1,2 A history of deep venous thrombosis (DVT) constitutes a well-known risk factor for its postoperative recurrence, 3 and venous stasis has been considered to be a major pathophysiological risk factor. 4,5 DVT sequelae of venous occlusion, valve destruction, or both lead to a short refill time, impaired calf muscle pump function, incomplete venous emptying, and increased ambulatory venous pressure. 6,7 These hemodynamic alterations tend to aggravate in the long term, resulting in the development of the postthrombotic syndrome. This progressively deteriorating venous stasis constitutes a major predisposing factor for DVT, in addition to any coexisting hematological cause. 8,9 Similarly, patients with varicose veins have also been reported to have an increased incidence of postoperative DVT, 9-12 probably for the same hemodynamic reasons. Venous thromboembolism is common among patients who are hospitalized and carries a significant morbidity rate in both the short term (pulmonary embolism, fatal or not) and the long term (post-thrombotic syndrome). Although most cases are now preventable by using mechanical, pharmacological, or combined prophylactic 915