Summary and Comment
New Compression Device to Prevent Deep Venous Thrombosis
In hip-replacement patients, a portable compression device was as effective as enoxaparin, without the bleeding complications.
To prevent deep venous thrombosis (DVT), an effective and well-tolerated mechanical compression device would be a welcome alternative to antithrombotic drugs. "Active Care + SFT" is a lightweight battery-operated portable device that synchronizes leg compressions to respiratory-related venous flow. It can be worn during ambulation and can be used at home after hospitalization.
In this randomized trial, sponsored by the device manufacturer, 410 patients who underwent total hip arthroplasty received 10 days of prophylaxis with the compression device or with enoxaparin (Lovenox). On lower-extremity duplex ultrasonography at 10 days, the incidence of DVT was 5% in both groups. Two patients in each group developed symptomatic pulmonary embolisms. Major bleeding occurred in 11 enoxaparin patients (6%) and in no patients in the device group.
Comment: In this study of DVT prophylaxis after hip replacement, a new portable mechanical compression device was as effective as enoxaparin and was not associated with major bleeding complications. Patients wore the device, which has an internal adherence monitoring system, for an average of 20 hours daily. The authors do not discuss cost or patient satisfaction in this report. However, if the device is similar to pharmacologic prophylaxis in cost and adherence, and if larger studies confirm its efficacy, it would represent an advance in postoperative DVT prophylaxis.
Journal Watch General Medicine April 1, 2010
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