PNEUMATIC CALF COMPRESSION, FIBRINOLYSIS, AND THE PREVENTION OF DEEP VENOUS THROMBOSIS

1 January 1980

journal article
research article

Vol. 88 (4) , 489-496

Abstract

In a previous study that did not reach statistical significance, intermittent single-leg pneumatic compression appeared effective in reducing the incidence of calf vein thrombosis not only in the pumped calf but also in the unpumped leg in 37 patients, using the 125I-fibrinogen technique. Mechanical induction of local and systemic fibrinolysis was investigated here. The euglobulin lysis time in the arm venous effluent was determined in 5 volunteers before and after unilateral arm compression for 1/2 h. Shortening averaged 19% (not significant). The experiment was repeated using bilateral calf-length boots with femoral vein sampling. Euglobulin lysis decreased 22% (P < 0.001). To uncover possible systemic effects, the protocol was altered using calf boots with sampling from the arm. The euglobulin lysis diminished 6% in 57 volunteers (P < 0.001). In 27 others the effects of thigh-length and calf-length boots were compared. In half, pumping with a short boot was undertaken first, and in the remainder, the long boot was applied initially. One-half hour of pumping was followed by 1/2 h of rest. Immediately afterward the 2nd period of pumping took place and continued for 1/2 h. Four arm vein samples were obtained, 1 before and after each pumping period. Although the 1/2 h rest period was unadequate to permit the subjects to return to basal conditions, statistically significant decreases in euglobulin lysis time (P = 0.05) occurred with the long boots. Intermittent calf compression increases fibrinolytic potential locally, this effect can be demonstrated systemically. The greater the tissue volume compressed, the greater the response. The efficacy of intermittent venous compression in reducing the incidence of deep venous thrombosis may be due, in part, to localized induction of fibrinolysis.

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