Weitz J, Michelsen J, Gold K, Owen J, Carpenter D.
Effects of intermittent pneumatic calf compression on postoperative thrombin and
plasmin activity.
Thromb Haemost 1986 Oct 21;56(2):198-201

A previous study of neurosurgical patients demonstrated an imbalance between
thrombin and plasmin action following surgery. The present study was designed to
determine the effect of intermittent pneumatic calf compression on postoperative
enzyme activity. Fibrinopeptide A (FPA) and B beta 1-42 levels, reflecting
thrombin and plasmin action respectively, were measured daily in patients
undergoing elective craniotomy. Two of 9 patients not receiving calf compression
developed positive fibrinogen leg scans, while none of 5 patients receiving
prophylaxis had positive scans. Calf compression was associated with a markedly
altered pattern of changes in the fibrinopeptide values following surgery.
Without compression, there was perturbation of the balance between thrombin and
plasmin action on the day after surgery as reflected by an increase in the FPA/B
beta 1-42 ratio. In contrast, in those receiving prophylaxis there was no change
in this ratio on the first postoperative day. Calf compression both blunted the
mean postoperative increase in the FPA level (1.8 nM vs 4.7 nM; p less than .05)
and augmented the mean B beta 1-42 value (3.0 nM vs 0.2 nM; p less than .05) so
that the mean increase in the FPA/B beta 1-42 ratio was only 0.1 with calf
compression as compared to 2.2 without it (p less than .05). Systemic modulation
of both the coagulation and fibrinolytic pathways thus occurred in association
with calf compression.