Intermittent Pneumatic Compression or Graduated Compression Stockings for Deep Vein Thrombosis Prophylaxis? A Systematic Review of Direct Clinical Comparisons

Objective: To review the relative efficacy of intermittent pneumatic compression (IPC) and graduated compression stockings (GCS) stated in direct clinical comparisons. Summary Background Data: Both IPC and GCS are recommended for deep vein thrombosis (DVT) prophylaxis in surgical patients. Although both are known to be effective, guidance is less clear on the clinical grounds for choosing between the 2 devices. Methods: Major medical databases were searched for trial reports published between January 1970 and August 2008. All trials comprising a direct clinical comparison between IPC and GCS were reviewed. Results: Ten direct comparisons were found, 9 of which were with surgical patients. The difference in DVT outcome only reached statistic significance in 3, all of which showed IPC to have the lower DVT rate. Five of the trials that did not produce statistic significance included fewer than 40 patients in each study group. The crude cumulated DVT rate for all the trials was 5.9% for GCS and 2.8% for IPC. Conclusion: There is only weak evidence to show a difference in performance between the devices, however, given the many influential factors, caution should be taken in assuming equivalence.