Hansberry KL, Thompson IM Jr, Bauman J, Deppe S, Rodriguez FR.
A prospective comparison of thromboembolic stockings and heparin
sodium/dihydroergotamine mesylate for the prevention of thromboembolic
complications in urological surgery.
J Urol 1991 Jun;145(6):1205-8

Radiology (Department of Surgery) Service, Brooke Army Medical Center, Fort Sam
Houston, Texas.

Deep venous thrombosis and pulmonary emboli are reported to occur in up to 66% of
the patients undergoing a major urological operation. Thromboembolic stockings,
external sequential pneumatic compression stockings and anticoagulant agents,
such as heparin sodium plus dihydroergotamine mesylate, have been suggested to
decrease the risk of deep venous thrombosis and pulmonary emboli. A total of 74
evaluable patients undergoing a major urological operation was randomized to
receive either thromboembolic stockings, external sequential pneumatic
compression stockings, or heparin plus dihydroergotamine as prophylaxis against
deep venous thrombosis and pulmonary emboli. 111Indium-labeled platelet scans,
performed preoperatively and on days 1, 3 and 6 postoperatively, were used to
diagnose deep venous thrombosis and pulmonary emboli. Mean patient age was 63
years and all but 1 operation was performed for neoplastic disease. Deep venous
thrombosis was detected in 5 of 25 patients (20%) with thromboembolic stockings,
3 of 24 (12.5%) with external sequential pneumatic compression stockings and 2 of
25 (8%) with heparin plus dihydroergotamine. There was no difference in blood
loss or complications among the groups. Although statistical significance among
the treatment groups was not reached in this study, the trend to a decrease in
deep venous thrombosis and pulmonary emboli with external sequential pneumatic
compression stockings and heparin plus dihydroergotamine, and an absence of an
increase in morbidity in these groups supports the use of these modalities to
decrease the morbidity and mortality of deep venous thrombosis and pulmonary
emboli.