title: Randomized controlled trial of a new portable calf compression device (Venowave) for prevention of venous thrombosis in high-risk neurosurgical patients.
abstract: BACKGROUND
  Patients undergoing neurosurgical procedures are at risk of venous thromboembolism (VTE), but often have contraindications for anticoagulant prophylaxis.
  
  
  OBJECTIVE
  To assess the efficacy and tolerability of a new, lightweight, portable, battery-powered, intermittent calf compression device, Venowave, for the prevention of VTE in neurosurgical inpatients.
  
  
  METHODS
  We performed an open randomized controlled trial comparing Venowave with control for the prevention of VTE in patients undergoing neurosurgery. The primary outcome was the composite of asymptomatic deep vein thrombosis (DVT) detected by screening venography or compression ultrasound performed on day 9 (± 2 days) and symptomatic VTE.
  
  
  RESULTS
  We randomized 75 patients to receive Venowave devices and 75 to the control group. All patients were prescribed graduated compression stockings and physiotherapy. VTE occurred in three patients randomized to Venowave and in 14 patients randomized to control (4.0% vs. 18.7%, relative risk 0.21; 95% confidence interval 0.05-0.75, P = 0.008). Similar reductions were seen for proximal DVT (2.7% vs. 8.0%) and symptomatic VTE (0% vs. 2.7%), and the results were consistent in all subgroups examined.
  
  
  CONCLUSIONS
  Venowave devices are effective in preventing VTE in high-risk neurosurgical patients.
authors.affiliation: Flinders Medical Centre, Bedford Park, SA, Australia. magdalena.sobieraj-teague@health.sa.gov.au
authors.forename: M
authors.initials: M
authors.lastname: Sobieraj-Teague
authors.forename: J
authors.initials: J
authors.lastname: Hirsh
authors.forename: G
authors.initials: G
authors.lastname: Yip
authors.forename: F
authors.initials: F
authors.lastname: Gastaldo
authors.forename: T
authors.initials: T
authors.lastname: Stokes
authors.forename: D
authors.initials: D
authors.lastname: Sloane
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Donnell
authors.forename: J W
authors.initials: JW
authors.lastname: Eikelboom
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D004867:Equipment Design; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010690:Phlebography; D026741:Physical Therapy Modalities; D011312:Pressure; D018570:Risk Assessment; D012307:Risk Factors; D053828:Stockings, Compression; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*