Effectiveness of intermittent pulsatile elastic stockings for the prevention of calf and thigh vein thrombosis in patienis undergoing elective knee surgery

Intermittent calf compression (ICC) prevents postoperative venous thrombosis (VT) but has not been previously tested in patients who remain immobilized for prolonged periods. We have evaluated a pulsatile elastic stocking in a randomized trial of 61 patients who underwent elective knee surgery. The stockings were worn for up to 17 days or until patient discharge and did not produce patient discomfort. The patients were well matched for age, sex, type of operation and aspirin use. Bilateral venography was performed on all patients 14–17 days postoperatively or earlier if the 1251-fibrinogen scan became positive. Nineteen of the 29 patients (65.5%) in the control group and 2 of 32 patients (6.3%) in the stocking group developed deep VT (p<0.001). Popliteal or femoral VT was found in 7 patients in the control group and in no patients in the stocking group (p<0.01). The effectiveness of ICC was not influenced by age, sex, previous venous disease or aspirin administration, although it is possible that aspirin may have provided some protection in the control group.