Labropoulos N, Oh DS, Golts E, Kang SS, Mansour MA, Baker WH.
Improved venous return by elliptical, sequential and seamless air-cell
compression.
Int Angiol. 2003 Sep;22(3):317-21.

Department of Surgery, Loyola University Medical Center, Maywood,
IL 60153-3304, USA. nlabrop@lumc.edu
AIM: The risk of deep vein thrombosis (DVT) in the peri-operative
period is significant, but can be reduced with the use of
mechanical intermittent pneumatic compression (IPC). These
devices have reached widespread use in hospitals and have been
found to be effective prophylactic measures against DVT. This
study evaluates the latest design features of one particular IPC
device in comparison to current models. METHODS: Duplex
ultrasound scanning was performed on 40 lower extremities of 20
healthy volunteers before and during the application of the IPC
device (VenaFlow System, Aircas, NJ, USA. Two hemodynamic
parameters were measured, acceleration time from spontaneous
baseline venous flow and peak vein velocity. All measurements
were obtained by scanning proximal to the saphenofemoral
junction in the common femoral vein in both extremities for each
subject. Data were obtained from 3 compression cycles and
averaged for each extremity. Results were compared with a recent
prospective study form our center using a slow-filling and a rapid-
filling sequential IPC devices. RESULTS: The medians for
spontaneous average peak velocities at rest of the right and left
lower extremities were 26 cm/s and 24.1 cm/s. The median
augmented peak velocities during the compression cycle of the
device in the right and left side were 79.6 cm/s and 79.0 cm/s. This represented a 306.2% increase in average peak velocity on the
right side and a 327.8% increase on the left side. The median
acceleration time was 305 ms +/- 40 in the left and 310 ms +/- 50
in the right limb. There was no statistically significant difference
in the spontaneous and augmented velocities between the right and
left lower extremities in each subject. In comparison to existing
slow- and rapid-filling IPC devices the VenaFlow System had
superior peak velocities and shorter acceleration times.
CONCLUSION: The use of elliptical, sequential and rapid-filling
compression of the leg with overlapping air-cells produces
significant hemodynamic changes in the common femoral vein,
which are superior to other sequential slow- or rapid-filling IPC
devices. Randomized studies should be performed to determine
the efficacy of this new device in DVT prevention.