Purpose of pneumatic compression device portable#
The purpose of this study is to evaluate the incidence of symptomatic VTE in patients undergoing outpatient TKA using an ASA -based risk-stratified protocol along with ambulatory portable pneumatic compression device as VTE prophylaxis.Ī retrospective review of all outpatient primary TKA procedures in which patients used ambulatory pneumatic compression pumps (Compression Solutions LLC, Tulsa, OK) as part of their multimodal VTE prophylaxis was performed from 2016 through 2018. The authors have published on the safety of outpatient arthroplasty however, a detailed analysis of VTE in this population has not been performed. The study authors have been performing outpatient TKA at a free-standing ambulatory surgery center since 2013 using an ASA -based, multimodal, and risk-stratified approach for venous thromboembolic disease prevention. In addition, prolonged outpatient use of pneumatic compression further decreases the incidence of VTE over isolated inpatient use. The symptomatic VTE rates using mechanical compression alone have been reported at 0.92%, which is comparable with more aggressive anticoagulation protocols. Īlong with anticoagulant medication, mechanical pneumatic compression has been shown to decrease rates of symptomatic VTE after TKA. Those patients with a higher risk profile including obesity and/or history of VTE are still commonly recommended to have a stronger prophylaxis rather than ASA. Furthermore, low-dose 81-mg ASA given twice daily has shown to be as effective as higher dose of 325-mg ASA. In many patients, ASA is as effective as Coumadin, low-molecular-weight heparin, and Factor Xa inhibitors in prevention of VTE. With these improvements in VTE prevention, chemoprophylaxis has shifted away from higher risk medications such as warfarin to drugs with a lower incidence of bleeding such as aspirin (ASA). Modern-day rates of symptomatic VTE have decreased substantially in part due to improvements in perioperative protocols and early mobilization, ,, ,, ]. The historically reported rates of VTE after lower extremity arthroplasty range from 1% to 15%, ,, ]. The goal of multimodal VTE prevention is to reduce each of these associated variables chemoprophylaxis targets the hypercoagulable state, while patient mobilization and mechanical pneumatic compression devices decrease venous stasis. VTE includes deep venous thrombosis (DVT) and/or pulmonary embolism (PE) and occurs as a result of Virchow’s triad: venous stasis, endothelial injury, and hypercoagulability. Although total knee arthroplasty (TKA) is overall a safe procedure, the risk of complications such as venous thromboembolism (VTE) still remains.
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