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Intermittent Pneumatic Compression

IPC therapy is delivered through inflatable, single-patient-use, garments containing one or more air chambers. These are applied to the foot, calf or calf and thigh and intermittently inflated with air by means of a powered pneumatic pump.

The inflation - deflation cycle simulates the normal ambulatory calf and foot pump and propels the blood of the deep veins towards the heart. This benefits the non-ambulatory patient by:

  • Increasing blood flow velocity in the deep veins and reducing stasis
  • Decreasing venous hypertension
  • Flushing valve pockets where it is thought thrombi originate
  • Decreasing interstitial oedema 1 

Biochemical effect

The mechanical forces of shear and stress within the venous system are linked to physiological responses in the endothelial cells that are thought to contribute to the anti-thrombotic and pro-fibrinolytic effects of IPC 2 (Figure 1).

Figure 1: Mechanical and biochemical effects of IPC on a vein. Diagram adapted from Chen et al (2001)2

Anti-thrombotic effect

IPC has been found to:

  • Increase levels of tissue factor pathway inhibitor (TFPI) 3,4 which is an important regulator of the initiating event in the blood coagulation system
  • Decrease levels of thrombin-antithrombin complex (TAT) 5 increasing the anti-thrombotic properties of the blood Another pathway, which IPC has been suggested to affect, is that of platelet disaggregation via the action of prostacyclin 2.

Maintaining haemostatic balance

Giddings et al (2004)4 examined specific coagulation and fibrinolytic markers in 21 subjects comparing the status before (control) and after both 60 and 120 minutes of IPC using a Flowtron DVT Prophylaxis System. The results confirmed that physiological blood flow plays a significant role in maintaining a haemostatic balance and reflects the potential value of IPC in clinical thrombosis management.

Compression type

The Flowtron DVT Prophylaxis System delivers a single-pulse compression profile, and an optimised inflation-deflation sequence, which delivers proximal blood flow augmentation at a level known to be effective for DVT prophylaxis. The circumferential compression garment is most commonly applied to the leg (calf-length or thigh-length) or, in some specialities such as orthopaedics, through application to the plantar plexus using a specialised foot garment

While there has been some debate in the past about the relative merits of ‘uniform’ versus ‘sequential’ compression, studies have consistently shown little difference. Results indicate comparable blood velocity and a trend towards greater peak flow augmentation with the Flowtron DVT Prophylaxis System 6, 7, 8, 9, 10. Both comparative patient studies and guideline consensus panels make little distinction between the two modalities.

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1  Kumar S, Walker M. The effects of intermittent pneumatic compression on the arterial and venous system of the lower limb: a review. Journal of Tissue Viability. 2002; 12(2): 58-65.
2 Chen A, Frangos S, Kilaru S et al. Intermittent pneumatic compression devices – physiological mechanisms of action. European Journal of Vascular and Endovascular Surgery. 2001; 21: 383-392.
3 Chouhan VD, Comerota AJ, Sun L. Inhibition of tissue factor pathway during intermittent pneumatic compression: a possiblemechanism for antithrombotic effect. Arteriosclerosis Thrombosis and Vascular Biology. 1999; 19: 2812-2817.
4 Giddings JC, Ralis H, Jennings G et al. Systemic haemostasis after intermittent compression. Clues for the investigation of DVT prophylaxis and traveller’s thrombosis. Clinical and Laboratory Haemotology. 2004; 26(4): 269-273.
5 Sutkowska E, Wozniewski M, Gamian A et al. Intermittent pneumatic compression in stable claudicants: effect on hemostasis and endothelial function. International Angiology. 2009; 28(5): 373-379.
6 Proctor MC, Zajkowski PJ, Wakefield TW et al. Venoushemodynamic effects of pneumatic compression devices. The Journal of Vascular Technology. 2001; 25(3): 141- 145.
7 Flam E, Berry S, Coyle A et al. DVT prophylaxis: comparison of two thigh high intermittent pneumatic compression systems. Presented at the meeting of the American College of Surgeons, San Francisco. 1993.
8 Flam E, Berry S, Coyle A et al. Blood flow augmentation of intermittent pneumatic compression systems used for the prevention of deep vein thrombosis prior to surgery. The American Journal of Surgery. 1996; 171(3): 312-315.
9 Westrich G, Specht LM, Sharrock NE et al. Venous haemodynamics after total knee arthroplasty: evaluation of active dorsal to plantar flexion and several mechanical compression devices. The Journal of Bone & Joint Surgery. 1998; 80B(6): 1057-1066.
10 Woodcock JP and Morris RJ. The effect of the Kendall SCD™ and Huntleigh DVT30 garments on femoral and popliteal vein blood flow measurements. ArjoHuntleigh Clinical Report. 2002.


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