External Pneumatic Compression of the Legs to Prevent Venous Thromboembolism in Neurosurgical Patients

Neurosurgical patients are at high risk of venous thrombosis (DVT) and pulmonary embolism (PE) but are poor candidates for antithrombotic drugs for fear of intracranial bleeding. Turpie et al. found external pneumatic compression of the legs (EPC) for five days prevented DVT while applied, but 10 days later EPC group and controls were not different. We compared EPC with inflatable boots vs.. untreated controls in 94 patients with trauma or operations of central nervous system or ruptured intracranial aneurysm, continuing EPC throughout period of bedrest (up to 17 days). Diagnosis of DVT was by ¹²⁵I-fibrinogen scan confirmed by phlebography in cases with positive scans. Results (Table) showed EPC gave significant protection against DVT in neurosurgical patients. There were no complications of EPC. There were no pulmonary emboli, even in the control group, so surveillance by ¹²⁵I-fibrinogen scan may help to prevent PE.