DVT Prevention: Intermittent Pneumatic Compression Devices

What are intermittent pneumatic compression devices?

Intermittent pneumatic compression (IPC) devices are used to help prevent blood clots in the deep veins of the legs. The devices use cuffs around the legs that fill with air and squeeze your legs. This increases blood flow through the veins of your legs and helps prevent blood clots.

Veins are the blood vessels that bring oxygen-poor blood and waste products back to the heart. Arteries are the blood vessels that bring oxygen-rich blood and nutrients from the heart to the body. Deep vein thrombosis (DVT) is a blood clot that forms in a vein deep inside the body. In most cases, this clot forms inside one of the deep veins of the thigh or lower leg.

The veins in your legs have tiny valves that help keep blood moving back up toward the heart. But a DVT may damage one or more of these valves. This causes them to weaken or become leaky. When this happens, blood starts to pool in your legs. This can also happen if you are immobile for a long period of time. Normally, muscles in the leg help blood move up in the veins when the muscles contract. When blood flows very slowly through the veins, this increases the risk that cells in the blood will stick together and form a clot.

DVT is a common condition. It's a higher risk in people older than 65. Post-thrombotic syndrome affects a large number of people who have had DVT. It can happen in people of any gender or age.

DVT is a serious medical condition that can cause swelling, pain, and soreness in your leg. In some cases, a deep clot in a leg vein can break free and travel through the bloodstream to the lungs. This can cause a blockage in the vessel called a pulmonary embolism. Pulmonary embolism can cause severe shortness of breath and even sudden death.

While using an IPC device, your calf or whole leg is enclosed in a cuff. The cuff fills with air and squeezes the leg, much like a blood pressure cuff. Then the cuff deflates and relaxes. The process then repeats over and over. The compression helps move blood through your veins towards your heart. IPC also promotes the natural release of substances in your body that help prevent clots. Between compressions, the cuffs of the device relax, and oxygen-rich blood continues to flow in the arteries of your leg.

Why might I need to use intermittent pneumatic compression devices?

You might need to use IPC devices if you have a high risk of getting a DVT. Anything that slows the movement of blood through your veins increases your risk of DVT. A variety of conditions can increase your chance of getting a DVT, such as:

• Recent surgery, which decreases your mobility and increases inflammation in the body, which can lead to clotting

• Health conditions that limit how much you can move, such as an injury or stroke

• Long periods of travel, which limit how much you can move

• Injury to a deep vein

• Inherited blood disorders that increase clotting

• Pregnancy

• Cancer treatment

• Smoking

• Obesity

• Older age

IPC is one way to help prevent DVT. A blood-thinning medicine such as warfarin is also used to treat people who are at high risk for DVT. These medicines may work better than compression devices in preventing DVT. But they have other risks. If you have a high risk of excess bleeding from a blood thinner, your healthcare provider may be more likely to advise IPC instead. In some cases, your provider might advise both blood thinners and IPC.

IPC is used most often for people who have just had surgery. It may also be used after a stroke or to help treat lymphedema.

What are the risks of using intermittent pneumatic compression devices?

All procedures have risks. The risks of this procedure include:

• Discomfort, warmth, or sweating beneath the cuff

• Skin breakdown

• Nerve damage (rare)

• Pressure injury (rare)

Careful attention to skin care can help prevent these complications. It’s also important that your cuff size is correct.

Some people with certain health conditions should not use IPC devices. For example, people with leg ulcers, burns, or peripheral vascular disease have a higher risk for problems. Older adults may be more at risk for skin breakdown. Talk with your provider about the risks that most apply to you and any concerns you may have.

How do I get ready for using intermittent pneumatic compression devices?

A healthcare provider may measure your leg, to make sure you get the right size cuff. If you are to use the device at home, you will also be instructed how to correctly put on the cuff. Be sure to ask any questions you have about the device or why it's being used.

What happens during the use of intermittent pneumatic compression devices?

In most cases, an IPC is used in the hospital. Or you may be instructed how to use it at home.

There are many types of IPC devices. Yours might cover your calf, or it might go around your whole leg. Some inflate all over the leg with the same pressure. Others may first apply pressure to the lower and then the upper part of the leg. Some inflate quickly, and others inflate slowly.

A healthcare provider will show you how to put on your IPC cuff. They often use Velcro straps to close. The cuff can be put on over or under your clothes, whichever is more comfortable. When fastened around your leg, the cuff should feel snug, but it shouldn’t hurt. You should be able to place a finger between the cuff and your leg.

Next, you attach the cuff to the compression machine. This machine will cycle between inflating and deflating the cuff. This may feel a little strange at first. Let your healthcare provider know if it is too uncomfortable. Changing the cuff to stop discomfort can help prevent complications.

You can remove your IPC cuff when you need to shower. Check your skin when the device is off and alert your provider if there are any areas of pain, swelling, warmth, redness, or skin breakdown. Make sure to put it back on as soon as possible. The more you use it, the more you will lower your risk of DVT and pulmonary embolism.

Your healthcare team may give you other instructions about what to do with your IPC device.

What happens after using intermittent pneumatic compression devices?

Your healthcare provider will tell you when you can stop using the device. This will be at the point where your risk of DVT goes down. If you have just had surgery, try to get up and move as soon as possible. With increased mobility, your risk of DVT will go down.

Your provider may give you other instructions about ways to prevent DVT. These may include drinking plenty of water and getting physical activity. Follow all your healthcare provider’s instructions.

Call your healthcare provider right away if you have any of these:

• Swelling in your leg

• A warm area on your leg

• Pain in your leg or on the skin under your cuff

• A sore on the skin under your cuff

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure