Prevention of venous thrombosis in patients with acute intracerebral hemorrhage.
OBJECTIVE
To assess intermittent pneumatic compression (IPC) in the prevention of venous thromboembolism (VTE).


METHODS
The authors randomly allocated patients with a documented intracerebral hemorrhage (ICH) to elastic stockings (ES) alone or combined with IPC. The primary outcome was a combined criteria assessed at day 10: a symptomatic and well-documented VTE, or a death arising before day 10 and related to pulmonary embolism (PE), or an asymptomatic deep vein thrombosis (DVT) of the lower limbs detected by compression ultrasonography (CUS). Outcome assessment was blinded.


RESULTS
One hundred fifty-one patients were randomized; 133 (88%) patients were evaluated at day 10. No clinical suspicion of VTE arose before day 10. Fourteen patients died before having a CUS but no death was definitely related to PE. Fourteen asymptomatic DVT were detected by CUS: three (4.7%) in the ES + IPC group (all distal) and 11 (15.9%) in the ES group (three proximal and eight distal). ES combined with IPC is associated with a reduced risk of asymptomatic DVT compared to ES alone: relative risk, 0.29 (95% CI 0.08 to 1.00).


CONCLUSIONS
Asymptomatic deep vein thrombosis (DVT) was detected at day 10 in 15.9% of patients wearing elastic stockings alone. Intermittent pneumatic compression significantly decreased the occurrence of asymptomatic DVT for patients with intracerebral hemorrhage.
Lacut
K
K
Groupe d'Etude de la Thrombose de Bretagne Occidentale, Equipe d'Accueil 3878, Cavale Blanche Hospital, Brest, France. karine.lacut@chu-brest.fr
Bressollette
L
L
Le Gal
G
G
Etienne
E
E
De Tinteniac
A
A
Renault
A
A
Rouhart
F
F
Besson
G
G
Garcia
J-F
JF
Mottier
D
D
Oger
E
E
D000208:Acute Disease / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects; D001458:Bandages / Q000592:standards / Q000706:statistics & numerical data*; D015984:Causality; D002543:Cerebral Hemorrhage / Q000150:complications*; D005260:Female; D005268:Femoral Vein / Q000503:physiopathology; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D048228:Intermittent Pneumatic Compression Devices / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D018579:Patient Selection; D012307:Risk Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000503:physiopathology / Q000517:prevention & control*
D000925:Anticoagulants; D006493:Heparin