Dr. Joseph M. Perlman Advanced Plastic Surgery Centre

The combination of leg compression and medication is more effective in preventing deep vein thrombosis (blood clots in deep veins) and pulmonary embolism (blood clots traveling to the lungs) in high-risk individuals than using either one of these treatments alone. This finding is based on data from 11 trials involving 7,431 patients.

Deep vein thrombosis and pulmonary embolism

Deep vein thrombosis (DVT) occurs when sitting still for long periods of time in cramped conditions, such as long car rides or plane trips. DVT also commonly develops during prolonged immobility, such as when undergoing surgery, bed rest, or hospitalization.

Most deep vein clots occur in the lower leg or thigh. They can cause inflammation of the involved vein, a condition called thrombophlebitis. The danger of DVT is that it can dislodge, travel in the bloodstream and cause blockage in the lungs (pulmonary embolism) or the heart (heart attack), or the brain (stroke).

Venous thromboembolism (DVT and pulmonary embolism) is often a complication of surgery and trauma. Patients undergoing total hip or knee replacement surgery or surgery for colorectal cancer are at high risk. Sluggish venous blood flow, increased blood clotting (the body’s tissue healing response) and blood clotting medications contribute to DVT.

Leg compression and heparin

Intermittent pneumatic leg compression, which uses a pump to inflate an airtight bag around the leg, reduces venous stasis (stagnant blood flow), while anticoagulants such as heparin, which thins the blood, reduce clotting.

The Cochrane researchers found that, compared with using heparin alone, a combined approach (heparin plus leg compression) reduced the risk of DVT from four in 100 to less than one in 100.

And when compared to using leg compression alone, the two modalities (methods of treatment) decrease the risk of DVT from 4 in 100 to 1 in 100.

Lead researcher Stavros Kakkos of the Henry Ford Hospital in Detroit, Michigan said that the results support the guidelines that already recommend the combined use of leg compression and medication for the prevention of DVT. The study, however, did not show the effect of the combined treatments on reducing the risk of pulmonary embolism.