Vascular boot warming improves clinical outcomes of patients with deep vein thrombosis in lower extremities

摘要

Objective: Vascular boot warming can increase venous return from the lower extremities, which may improve clinical outcomes of patients with deep vein thrombosis (DVT). In this study, we included vascular boot (Boot) warming in the standard of care (SOC) of patients with DVT and explored its safety and efficacy. Methods: Subjects diagnosed with acute DVT of the lower extremities were included in this study. The subjects (n=104) were then randomized into the SOC group (n=51) and the SOC + Boot group (n=53) and followed up for 3 months. All subjects received anticoagulants as standard of care. The patients in the SOC + Boot group wore vascular boots for a minimum of 3 times in a day, for 45 minutes each time for the first 14 days. Pain, swelling, major bleeding, pulmonary embolism (PE), extended proximal DVT, and mortality were evaluated at day 1, day 14 and at 3 months. Results: Compared with the patients in the SOC group, the patients in the SOC + Boot group had a lower rate of pain (3.8±1.5 vs 5.4±0.9 by 14 days, 2.3±0.9 vs 3.1±1.2 by 3 months, all P0.05), faster swelling reduction (circumference difference compared to day 1 at the ankle level was -0.29±0.44 cm vs 1.21±0.63 cm by 14 days, -0.45±0.43 cm vs 0.15±0.19 cm by 3 months, all P0.05), lower incidence of PE (1.9% vs 3.9%, RR 2.0% by 14 days, 2.8% vs 5.9%, RR 3.1%, by 3 months, both P0.05), lower incidence of proximal DVT (1.9% vs 5.9%, RR 4%, by 14 days, 3.8% vs 7.8%, RR 4% by 3 months, both P0.05), and lower mortality (1.9% vs 3.9% by 14 days and 3 months, P0.05). No major bleeding was observed in either group. These results suggest that implementing vascular boot warming in SOC can improve clinical outcomes in patients with lower extremity DVT. Conclusion: Vascular boot warming, as an add-on to SOC, is safe and effective for patients with lower extremity DVT and can help to prevent post-thrombotic events.