Reduced risk of venous thromboembolism with the use of intermittent pneumatic compression after craniotomy: a randomized controlled prospective study

被引:21
作者
Prell, Julian [1 ]
Schenk, Grit [1 ]
Taute, Bettina-Maria [2 ]
Scheller, Christian [1 ]
Marquart, Christian [1 ]
Strauss, Christian [1 ]
Rampp, Stefan [1 ]
机构
[1] Univ Halle, Dept Neurosurg, Halle, Germany
[2] Univ Halle, Dept Angiol, Halle, Germany
关键词
venous thromboembolism; deep venous thrombosis; intermittent pneumatic compression; craniotomy; DEEP-VEIN THROMBOSIS; PULMONARY-EMBOLISM; LOWER-LIMB; PREVENTION; PROPHYLAXIS; HISTORY; SURGERY; CANCER;
D O I
10.3171/2017.9.JNS17533
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE The term "venous thromboembolism" (VTE) subsumes deep venous thrombosis (DVT) and pulmonary embolism. The incidence of DVT after craniotomy was reported to be as high as 50%. Even clinically silent DVT may lead to potentially fatal pulmonary embolism. The risk of VTE is correlated with duration of surgery, and it appears likely that it develops during surgery. The present study aimed to evaluate intraoperative use of intermittent pneumatic compression (IPC) of the lower extremity for prevention of VTE in patients undergoing craniotomy. METHODS A total of 108 patients undergoing elective craniotomy for intracranial pathology were included in a single-center controlled randomized prospective study. In the control group, conventional compression stockings were worn during surgery. In the treatment group, IPC of the calves was used in addition. The presence of DVT was evaluated by Doppler sonography pre- and postoperatively. RESULTS Intraoperative use of IPC led to a significant reduction of VTE (p = 0.029). In logistic regression analysis, the risk of VTE was approximately quartered by the use of IPC. Duration of surgery was confirmed to be correlated with VTE incidence (p < 0.01); every hour of surgery increased the risk by a factor of 1.56. CONCLUSIONS Intraoperative use of IPC significantly lowers the incidence of potentially fatal VTE in patients undergoing craniotomy. The method is easy to use and carries no additional risks.
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页码:622 / 628
页数:7
相关论文
共 37 条
[1]   Enoxaparin plus compression stockings compared with compression stockings alone in the prevention of venous thromboembolism after elective neurosurgery [J].
Agnelli, G ;
Piovella, F ;
Buoncristiani, P ;
Severi, P ;
Pini, M ;
D'Angelo, A ;
Beltrametti, C ;
Damiani, M ;
Andrioli, GC ;
Pugliese, R ;
Iorio, A ;
Brambilla, G .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (02) :80-85
[2]  
Algattas H, 2017, NEUROSURGERY
[3]  
Auguste Kurtis I, 2004, Neurosurg Focus, V17, pE3
[4]   Virchow and his triad: a question of attribution [J].
Bagot, Catherine N. ;
Arya, Roopen .
BRITISH JOURNAL OF HAEMATOLOGY, 2008, 143 (02) :180-190
[5]   Nomenclature of the veins of the lower limb: Extensions, refinements, and clinical application [J].
Caggiati, A ;
Bergan, JJ ;
Gloviczki, P ;
Eklof, B ;
Allegra, C ;
Partsch, H .
JOURNAL OF VASCULAR SURGERY, 2005, 41 (04) :719-724
[6]  
CALNAN JS, 1970, LANCET, V2, P502
[7]   Venous thromboembolism occurs frequently in patients undergoing brain tumor surgery despite prophylaxis [J].
Chan, AT ;
Atiemo, A ;
Diran, LL ;
Licholai, GP ;
Black, PM ;
Creager, MA ;
Goldhaber, SZ .
JOURNAL OF THROMBOSIS AND THROMBOLYSIS, 1999, 8 (02) :139-142
[8]   WHY DOES PROPHYLAXIS WITH EXTERNAL PNEUMATIC COMPRESSION FOR DEEP-VEIN THROMBOSIS FAIL [J].
COMEROTA, AJ ;
KATZ, ML ;
WHITE, JV .
AMERICAN JOURNAL OF SURGERY, 1992, 164 (03) :265-268
[9]   The fibrinolytic effects of intermittent pneumatic compression - Mechanism of enhanced fibrinolysis [J].
Comerota, AJ ;
Chouhan, V ;
Harada, RN ;
Sun, L ;
Hosking, J ;
Veermansunemi, R ;
Comerota, AJ ;
Schlappy, D ;
Rao, AK .
ANNALS OF SURGERY, 1997, 226 (03) :306-313
[10]  
Danish Shabbar F, 2004, Neurosurg Focus, V17, pE2