PreVent DVT Solution Built Upon AAOS VTE Recommendations

AAOS Guidelines, Mechanical Prophylaxis is the only recommended DVT Prophylaxis method that is sufficient by itself or in combination with

Recommended DVT Protocol by Leading Organizations

AAOS on “At Home” risk

If you are having orthopaedic surgery, your risk for developing DVT is highest from 2 to 10 days after surgery and includes the time after you have been discharged from the hospital. You remain at risk for about 3 months

AAOS Symposium on Recommended DVT Protocol

To further complete the uniformity of approach in the United States, the Center for Medicare and Medicaid Services (CMS), which administers the Surgical Care Improvement Program (SCIP) that monitors hospital compliance with VTE prophylaxis of hospitalised patients, has also changed their policy. The remarkable success reported from many centres 17-19 with the use of aspirin and/or the use of a mobile compression device in patients without major risk factors, such as a prior history of symptomatic VTE, clearly indicate that aggressive pharmacoprophylaxis is not necessary for the vast majority of patients who undergo joint replacement. AAOS

AJO on Why At Home Prevention is Vital

However, 45% to 80% of all symptomatic VTE events occur after hospital discharge

Evolution of DVT Prevention in Orthopedics

Two types of VTE prophylaxis

Pharmacological

MECHANICAL PROPHYLAXIS (IPCS)

Inhibiting blood coagulation but can be accompanied by bleeding risks Squeezing the limb preventing stagnation of blood, known to decrease bleeding risks

How Does PreVent Work?

No Cost Mobile DVT Prevention Device

Circul8 is an easy to use sequential compression system, prescribed by a physician

Patient Tracking App

Circul8 App is the first patient monitoring application to help guide patients through their DVT prevention journey,

Provider Dashboard

Circul8 is an easy to use sequential compression system, prescribed by a physician

Reimbursable DVT Remote Patient Monitoring

This guide is provided to assist you in understanding Medicare digitally stored data services

Gold Standard of DVT Prevention Care

DVT Protocol Recommendations Have Changed Over the Years

Use the First At Home DVT Prevention & Monitoring Platform that Reimburses you

2004 ACCP Guidelines:3

In 2004, the American College of Chest Physicians (ACCP) preferred to use pharmacological methods of prophylaxis as the primary DVT prevention measure in major orthopedic surgery:

  • They stated that mechanical methods, including IPCs and graduated compression stockings (GCS), were not acceptable as alternatives in hip arthroplasty.
  • IPCs would be preferred over pharmacological measures in hip fracture surgery only if there was increased bleeding risk.

2008 ACCP Guidelines:4

The ACCP revised its guidelines in 2008. Its only concession to IPCs was with regard to hip arthroplasty surgery. They recommended that like hip fracture surgery, hip arthroplasty patients could be given mechanical prophylaxis using IPCs if there was increased risk of bleeding. They also stated that once the risk of bleeding had passed, pharmacological prophylaxis should be initiated as soon as possible.

2011 AAOS Guidelines:2

The American Academy of Orthopaedic Surgeons (AAOS) in 2011 recommendations:

  • In patients who did not have increased risk of VTE or bleeding (apart from the surgery itself), either pharmacological or mechanical prophylaxis could be used.
  • If patients/procedures were at increased risk of bleeding, mechanical prophylaxis alone was to be preferred.

2012 ACCP Guidelines:6

In 2012, the ACCP first acknowledged that pneumatic compression devices could be as effective as
pharmacological prophylaxis.

  • The minimum duration of prophylaxis was set at 10-14 days, but they suggested that prophylaxis be continued during the outpatient period for 30 to 35 days.
  • They further recommended that if an IPC was used, it should be portable, battery-powered, and capable of recording the wear time to ensure maximum compliance.
  • In patients with increased risk of bleeding, IPCs should be preferred over pharmacological prophylaxis.
  • In patients with high risk of VTE, both pharmacological and mechanical methods should be used for effective prophylaxis.

2015 AAOS Hip Symposium

They recommended the following:

  • Surgical Care Improvement Program (SCIP) recently announced that beginning January, 2014, either aspirin or a compression device will be considered as acceptable measures for THR, TKR and hip fracture.16
  • The remarkable success reported from many centres17-19 with the use of aspirin and/or the use of a mobile compression device in patients without major risk factors, such as a prior history of symptomatic VTE, clearly indicate that aggressive pharmacoprophylaxis is not necessary for the vast majority of patients who undergo joint replacement.

2019 American Society of Hematology Guidelines:7

They recommended the following:

  • For any surgery, mechanical or pharmacological prophylaxis can be chosen. For mechanical prophylaxis, IPCs should be used.
  • If pharmacological prophylaxis is chosen, either aspirin or anticoagulant medication can be used. Their order of preference for anticoagulants is directly-acting oral anticoagulants, followed by LMWH, followed by warfarin.
  • Combined mechanical and chemical prophylaxis is more effective than either method alone, and should be considered after taking the risk factors into account.

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