Among patients with a Caprini score of ≥11 who received standard prophylaxis for venous thromboembolism (VTE), adjunctive intermittent pneumatic compression (IPC) resulted in a significantly lower incidence of asymptomatic venous thrombosis.
This is according to the findings of the IPC SUPER (IPC in addition to standard prophylaxis of postoperative VTE in extremely high-risk patients) randomised controlled trial, published in the latest edition of Annals of Surgery.
Authors Kirill Lobastov (Pirogov Russian National Research Medical University, Moscow, Russia) and colleagues recall that, prior to conducting their study, the standard prophylaxis for postoperative VTE was “insufficient” in extremely high-risk patients. In addition, it was previously “unclear whether an adjunctive use of IPC would result in a lower incidence of postoperative venous thrombosis”, they write.
In order to address this gap in the literature, the investigators randomly assigned patients who underwent major surgery and had a Caprini score of ≥11 to receive either IPC in addition to standard prophylaxis with anti-embolic stockings (pressure of 18–21mmHg at the ankle) and low-molecular-weight heparin (IPC group) or standard prophylaxis alone (control group).
A total of 407 patients underwent randomisation, the authors relay, noting that 204 were assigned to the IPC group and 203 to the control group. Writing in Annals of Surgery, Lobastov et al report that the primary outcome of an asymptomatic venous thrombosis of the lower limbs occurred in one (0.5%) patient in the IPC group compared 34 (16.7%) patients in the control group (relative risk, 0.03; 95% confidence interval [CI], 0.01–0.21).
Furthermore, they add that pulmonary embolism occurred in none of the 204 patients in the IPC group and in five (2.5%) patients in the control group (relative risk, 0.09; 95% CI, 0.01–1.63), and postoperative death occurred in six (2.9%) patients in the IPC group and 10 (4.9%) in the control group (relative risk, 0.5%; 95% CI, 0.5–1.6).