Goldhaber SZ, Hirsch DR, MacDougall RC, Polak JF, Creager MA, Cohn LH.
Prevention of venous thrombosis after coronary artery bypass surgery (a
randomized trial comparing two mechanical prophylaxis strategies).
Am J Cardiol 1995 Nov 15;76(14):993-6

Department of Medicine, Brigham and Women's Hospital, Harvard Medical School,
Boston, Massachusetts 02115, USA.

Although venous thrombosis may occur often after coronary artery bypass grafting,
prophylaxis with low-dose heparin is rarely used due to the risk of bleeding.
Therefore, we compared the efficacy of 2 mechanical regimens of prophylaxis
against deep vein thrombosis (DVT). Consecutive patients undergoing coronary
artery bypass without concomitant valve surgery or coronary endarterectomy were
randomized to either a more intensive regimen of intermittent pneumatic
compression (IPC) plus graduated compression stockings (GCS) versus standard
compression stockings alone. Of 611 patients screened, 184 were excluded due to
peripheral vascular disease, postoperative intraaortic balloon support, or
immediate postoperative anticoagulation. An additional 83 patients refused
consent, leaving 172 in each prophylaxis group. The primary study end point was
DVT diagnosed by a predischarge leg ultrasound examination performed on
postoperative days 4 to 6. Of 344 patients enrolled, 330 (96%) underwent
predischarge ultrasonography. DVT was detected in 19% of patients assigned to IPC
plus stockings versus 22% assigned to GCS alone (95% confidence interval for the
difference, -11% to 6%, p = 0.62). The addition of IPC did not add significant
incremental benefit to GCS alone for DVT prophylaxis among patients undergoing
coronary artery bypass surgery.