title: Prevention of venous thromboembolic complications with and without intermittent pneumatic compression in neurosurgical cranial procedures using intraoperative magnetic resonance imaging. A retrospective analysis.
abstract: OBJECTIVE
  To evaluate the introduction of intraoperative and postoperative pneumatic compression additionally to the use of compression stockings, low molecular weight heparin-LMWH and early mobilization, a retrospective study in cranial neurosurgery using intraoperative MRI was performed.
  
  
  METHODS
  A retrospective analysis of 207 neurosurgical patients using intraoperative MRI was performed. A group of 86 patients was treated with the additional use of intraoperative and postoperative pneumatic compression until mobilization out of bed. One hundred twenty-one patients were treated without the use of additional pneumatic compression. Postoperatively the patients were screened for deep venous thrombosis by ultrasound and pulmonary embolism by CT-scan if suspicious. Statistical analysis was performed.
  
  
  RESULTS
  The development of deep venous thrombosis was reduced from 9.9% to 3.5% in our patients with the additional use of intraoperative and postoperative pneumatic compression. That is a 64.6% relative risk reduction to develop deep venous thrombosis with the use of intraoperative and postoperative pneumatic compression. An additional 52% relative risk reduction was found for the chance of developing pulmonary embolism. In the 15 patients with detected deep venous thrombosis, the OR-time was more than 100 min longer than in the 192 patients without detected deep venous thrombosis. The difference between both groups was significant.
  
  
  CONCLUSIONS
  This study demonstrates the benefit of pneumatic compression with a risk reduction for the development of thromboembolic complications. OR-time is another risk factor that attributes to a significant risk for the development of thromboembolic complications.
authors.affiliation: Department of Anesthesiology, International Neuroscience Institute, Hannover, Germany.
authors.forename: Jobst
authors.initials: J
authors.lastname: Frisius
authors.affiliation: Medical School, Hannover, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Ebeling
authors.affiliation: Department of Anesthesiology, Medical School, Hannover, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Karst
authors.affiliation: Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Fahlbusch
authors.affiliation: Department of Internal Medicine, Medical School, Hannover, Germany.
authors.forename: Ingolf
authors.initials: I
authors.lastname: Schedel
authors.affiliation: Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany.
authors.forename: Venelin
authors.initials: V
authors.lastname: Gerganov
authors.affiliation: Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany.
authors.forename: Amir
authors.initials: A
authors.lastname: Samii
authors.affiliation: Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany. Electronic address: Luedemann@ini-hannover.de.
authors.forename: Wolf
authors.initials: W
authors.lastname: Lüdemann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D017063:Outcome Assessment, Health Care; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight
keywords: Intermittent pneumatic compression; Intraoperative magnetic resonance imaging; Neurosurgery; Venous thromboembolism