Prospective randomized trial of warfarin and intermittent pneumatic leg compression as prophylaxis for postoperative deep venous thrombosis in major urological surgery.

Postoperative deep venous thrombosis and pulmonary embolus remain a major source of morbidity and mortality for the urological surgery patient. We report the results of the first 100 patients in a prospective, randomized trial of low dose warfarin and intermittent pneumatic leg compression for deep venous thrombosis prophylaxis. All patients underwent preoperative and postoperative real-time ultrasound imaging and Doppler flow studies of the popliteal, femoral and iliac veins for the evaluation of deep venous thrombosis. Our results indicate that low dose warfarin is as effective as intermittent pneumatic leg compression for prophylaxis of deep venous thrombosis. Low dose warfarin can be used effectively without any significant bleeding complications. We recommend the use of low dose warfarin as an alternative to intermittent pneumatic leg compression for deep venous thrombosis prophylaxis of the urological patient undergoing a major urological operation.