Clinical Significance of Coagulation Biomarkers in Venous Pressure Therapy for Preventing Lower-Extremity Deep Venous Thromboembolism: A Meta-Analysis
Coagulation Biomarkers in Venous Pressure Therapy
Abstract
Background: To evaluate the biochemical and clinical significance of venous pressure therapy in preventing venous thromboembolism (VTE) through analysis of coagulation and fibrinolysis biomarkers, including fibrinogen (FIB), D-dimer (D-D), and activated partial thromboplastin time (APTT).
Methods: Randomized controlled trials published between 2013 and 2025 were systematically retrieved from PubMed, CNKI, VIP, and Wanfang databases. Eligible studies investigated venous pressure therapy and reported coagulation-related indices. Pooled effect sizes were calculated for key biochemical markers (FIB, D-D, APTT, PT, TT) and venous hemodynamic outcomes.
Results: Nineteen clinical studies met inclusion criteria. Meta-analysis revealed that venous pressure therapy significantly reduced plasma FIB and D-D levels, prolonged APTT, prothrombin time (PT), and thrombin time (TT), and improved venous blood flow velocity. These changes reflect improved anticoagulant activity, enhanced fibrinolysis, and reduced risk of thrombosis. Importantly, the observed modulation of biochemical markers correlated with a lower incidence of lower-extremity deep venous thrombosis.
Conclusion: Venous pressure therapy favorably alters coagulation and fibrinolytic biomarkers, underscoring their diagnostic value in monitoring therapeutic efficacy and thrombotic risk. These findings highlight the critical role of laboratory indices in guiding the prevention and management of VTE, supporting their integration into standardized clinical practice.
References
2. Varrias D, Spanos M, Kokkinidis DG, Zoumpourlis P, Kalaitzopoulos DR. Venous Thromboembolism in Pregnancy: Challenges and Solutions. Vasc Health Risk Man 2023; 19: 469-84.
3. Speth J. Guidelines in Practice: Prevention of Venous Thromboembolism. Aorn J 2023; 118(5): 321-8.
4. Riyahi S, Hectors SJ, Prince MR, Sweeney EM, Lane EG, Honya R, et al. Predictors of acute deep venous thrombosis in patients hospitalized for COVID-19. Medicine 2021; 100(38): e27216.
5. Lin L, Liang Z, Li Z, Zheng X. Effect of plan-do-check-active method combined with air pressure wave therapy on the prevention of deep venous thrombosis in critically ill patients in neurosurgery. Ann Palliat Med 2023; 12(1): 103-10.
6. Zeng Tingting. Clinical value of intermittent pneumatic compression in preventing lower-limb deep venous thrombosis after radical surgery for rectal cancer. Thrombosis and Hemostasis 2018; 24(2): 280–281.
7. Chen Yajing, Han Guijun. Effect of intermittent pneumatic compression devices on deep venous thrombosis of the lower limbs in critically ill patients. Hebei Medicine 2018; 24(2): 239–242.
8. Chen Fengmei, Liu Li, Xu Changli, et al. Application of an air pressure wave therapy device in preventing deep venous thrombosis in patients undergoing total knee arthroplasty. Journal of Naval Medicine 2023; 44(10): 1047–1050.
9. Bai Xiaoyan, Tai Xiuli, Zhang Yufeng. Effect of air pressure wave therapy combined with conventional measures on preventing lower-limb deep venous thrombosis after laparoscopic surgery for benign gynecologic tumors. Journal of Clinical and Pathology 2022; 42(9): 2152–2158.
10. Shao Lihua. Roles of an air pressure wave therapy device and medical compression stockings in preventing lower-limb deep venous thrombosis in patients with mild hypothermia. Chinese Community Doctor 2019; 35(30): 72–73.
11. Cui Yan, Huang Yaxue, Dong Yan. Preventive effect of lower-limb air pressure pumps on venous thromboembolism in patients with hypertensive disorders of pregnancy. Journal of Guangxi Medical University 2021; 38(3): 574–577.
12. Liu Siting. Effect of using an air wave pressure therapy device to prevent postoperative lower-limb deep venous thrombosis in patients undergoing gynecologic abdominal surgery. Thrombosis and Hemostasis 2019; 25(1): 159–160+162.
13. Sun Weilin, Liu Lili. Prevention of lower-limb deep venous thrombosis after cesarean section using an air pressure wave therapy device. Thrombosis and Hemostasis 2019; 25(6): 967–968.
14. Li Ruijuan, Ji Jianping, Jiang Jinsheng, et al. Effects of an air pressure therapy device on coagulation function and incidence of DVT in long‑term bedridden patients after stroke. Journal of Preventive Medicine of the Chinese People’s Liberation Army 2019; 37(9): 13–15.
15. von Tempelhoff GF, Nieman F, Heilmann L, Hommel G. Association between blood rheology, thrombosis and cancer survival in patients with gynecologic malignancy. Clin Hemorheol Micro 2000; 22(2): 107-30.
16. Huang H, Pan J, Han Y, Zeng L, Liang G, Yang W, et al. Chinese Herbal Medicines for Promoting Blood Circulation and Removing Blood Stasis for Preventing Deep Venous Thrombosis after Total Hip Arthroplasty: A Systematic Review and Meta-Analysis. Comb Chem High T Scr 2021; 24(7): 893-907.
17. Zhao W, Zhang W, Zhang Y. Characteristics of Deep Venous Thrombosis in Isolated Lower Extremity Fractures and Unsolved Problems in Guidelines: A Review of Recent Literature. Orthop Surg 2022; 14(8): 1558-68.
18. Ruan Y, Wang F, Du X, Sun S. Rehabilitation nursing after lower limb fracture: Preventing deep vein thrombosis and enhancing quality of life. Medicine 2023; 102(47): e36180.
19. Liu X, Chen X, Li Z, Wang S, Chen C. Anatomical distribution of lower-extremity deep venous thrombosis in patients with acute stroke. J Stroke Cerebrovasc 2020; 29(7): 104866.
20. Harbsmeier AN, Altintas I, Iversen K, Andersen O, Nehlin JO. Biomarkers and the post-thrombotic syndrome: A systematic review of biomarkers associated with the occurrence of the post-thrombotic syndrome after lower extremity deep venous thrombosis. Phlebology 2023; 38(9): 577-98.
21. Hang L, Haibier A, Kayierhan A, Abudurexiti T. Risk factors for deep vein thrombosis of the lower extremity after total hip arthroplasty. Bmc Surg 2024; 24(1): 256.
22. Xing J, Fu Y, Song Z, Wang Q, Ma T, Li M, et al. Predictive model for deep venous thrombosis caused by closed lower limb fracture after thromboprophylactic treatment. Eur Rev Med Pharmaco 2022; 26(22): 8508-22.
23. Prell J, Schenk G, Taute B, Scheller C, Marquart C, Strauss C, et al. Reduced risk of venous thromboembolism with the use of intermittent pneumatic compression after craniotomy: a randomized controlled prospective study. J Neurosurg 2019; 130(2): 622-8.
24. Wang J, Lin Y, Wang L, Xu F, Gao Y, Li C, et al. [Effect of intermittent pneumatic compression on coagulation function and deep venous hemodynamics of lower limbs after rectal cancer resection]. Zhonghua Wei Chang Wai Ke Za Zhi 2013; 16(8): 739-43.
25. Hattab Y, Kung S, Fasanya A, Ma K, Singh AC, DuMont T. Deep Venous Thrombosis of the Upper and Lower Extremity. Crit Care Nurs Q 2017; 40(3): 230-6.
26. Kumar J, Sahito B, Katto MS, Rasheed N, Jatoi AA, Abro A. The prevalence of deep Venous thrombosis of the lower extremity in hospitalised bedridden orthopaedic patients: a pilot study. J Pak Med Assoc 2023; 73(6): 1251-4.
27. Puerto Nino AK, Brignardello-Petersen R. How To Read a Network Meta-analysis. Eur Urol Focus 2023; 9(5): 701-4.
28. Hu M, Ma Y, Jia K, Liu S, Jing H, Li R. Analysis of coagulation alteration and its correlation with beta2-microglobulin in 371 patients with newly diagnosed multiple myeloma. Hematology 2024; 29(1): 2377849.
29. Chen L, Xu W, Chen J, Zhang H, Huang X, Ma L, et al. Evaluating the clinical role of fibrinogen, D-dimer, mean platelet volume in patients with acute exacerbation of COPD. Heart Lung 2023; 57: 54-8.
Copyright (c) 2025 Jingrong Niu, Shuang Zhou, Lijin Zhang, Chunmin Li, Hualiang Ren

This work is licensed under a Creative Commons Attribution 4.0 International License.
The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
