gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Intraoperative intermittent pneumatic compression reduces incidence of venous thromboembolism in patients undergoing craniotomy: A randomized prospective study

Meeting Abstract

  • Julian Prell - University of Halle-Wittenberg, Neurosurgery, Halle (Saale), Deutschland
  • Grit Schenk - University of Halle-Wittenberg, Neurosurgery, Halle (Saale), Deutschland
  • Bettina-Maria Taute - University of Halle-Wittenberg, Angiology, Halle (Saale), Deutschland
  • Christian Scheller - Universitätsklinikum Halle-Wittenberg, Neurochirurgische Klinik, Halle (Saale), Deutschland
  • Christian Strauss - Universitätsklinikum Halle/Saale, Klinik und Poliklinik für Neurochirurgie, Halle/Saale, Deutschland
  • Stefan Rampp - University of Halle-Wittenberg, Neurosurgery, Halle (Saale), Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.06.06

doi: 10.3205/17dgnc214, urn:nbn:de:0183-17dgnc2146

Published: June 9, 2017

© 2017 Prell et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: The term venous thromboembolism (VTE) subsumes deep venous thrombosis (DVT) and pulmonary embolism. The incidence of deep venous thrombosis (DVT) after craniotomy is reported to be as high as 50%. Even clinically silent DVT may lead to potentially fatal pulmonary embolism. The risk for VTE is correlated with duration of surgery, and it appears likely that it develops during surgery. The present study aims to evaluate intraoperative use of intermittent compression of the lower extremity (IPC) for prevention of VTE in patients undergoing craniotomy.

Methods: 108 patients undergoing elective craniotomy for intracranial pathology were included into a monocentric controlled randomized prospective study. In the control group, routine compression stockings were worn during surgery. In the treatment group, IPC of the calves was used in addition. The presence of DVT was evaluated by Doppler-sonography pre- and postoperatively. In addition, D-dimer plasma levels, which are known to be correlated with the incidence of VTE, were measured on the third day after surgery.

Results: Intraoperative use of IPC led to a significant reduction of VTE (p = 0.029); when both legs were accounted for separately, high significance was reached (p < 0.001). In logistic regression analysis, the risk for VTE was approximately quartered by use of IPC. Duration of surgery was confirmed to be correlated with VTE-incidence (p<0.01); every hour of surgery increased the risk by a factor of 1.56. The ability of postoperative D-dimer plasma levels to predict VTE was influenced by IPC, which led to a poor positive predictive value in the treatment group (16.7%). Nevertheless, VTE was still ruled out by D-dimer <2.0mg/l in both groups with >93%.

Conclusion: Intraoperative use of IPC significantly lowers the incidence for potentially fatal VTE in patients undergoing craniotomy. The method is easy to use and carries no additional risks.