Vanek VW.
Meta-analysis of effectiveness of intermittent pneumatic compression devices with
a comparison of thigh-high to knee-high sleeves.
Am Surg 1998 Nov;64(11):1050-8

Department of Surgery, St. Elizabeth Health Center, Youngstown, Ohio 44501, USA.

This meta-analysis used all original articles from 1966 to June 1996 that fit the
preset inclusion criteria to examine the clinical effectiveness of intermittent
pneumatic compression (IPC) devices in preventing deep vein thrombosis (DVT) and
pulmonary embolism and to compare the results of knee-high sleeves to thigh-high
sleeves. IPC devices decreased the relative risk of DVT by 62 per cent when
compared with placebo, 47 per cent compared with graduated compression stockings,
and 48 per cent compared with mini-dose heparin. IPC devices significantly
decreased the relative risk of DVT compared with placebo in high-risk patients
such as neurosurgery and major orthopedic surgery patients and in modest risk
patients such as general surgery patients. In major orthopedic surgery patients,
the incidence of DVT was similar for IPC- and warfarin-treated patients; however,
IPC was significantly better than warfarin at decreasing the incidence of calf
only DVT, whereas warfarin seemed to be better at decreasing proximal DVT. IPC
devices are effective in decreasing the incidence of DVT in patients at moderate
to high risk and are probably more efficacious than graduated compression
stockings or mini-dose heparin; however, IPC devices are not protective against
pulmonary embolism. The data directly comparing the various methods of
compression (knee-high versus thigh-high sleeves and graded-sequential versus
uniform compression) are sparse and conflicting.