Multi-modal prevention and treatment system for perioperative deep vein thrombosis (DVT) using integrated traditional Chinese and Western medicine

Zero pulmonary embolism in the perioperative period

National Health Commission’s core indicators of clinical pathways and surgical quality and safety; Recommended Guidelines for the Prevention of Deep Vein Thrombosis by the Surgery Branch of the Chinese Medical Association · Zero pulmonary embolism in the perioperative period / major national technical plan

Integrate modern intermittent pneumatic pressure pump (IPC), low-molecular-weight heparin targeted anticoagulation and classic traditional Chinese medicine prescriptions of "activating blood circulation, removing blood stasis, promoting qi and diluting water" to build a comprehensive intelligent early warning and active blocking closed-loop system for perioperative deep vein thrombosis (DVT) and fatal pulmonary embolism (PE) in major orthopedic surgery and long-term bedridden critically ill patients, while ensuring a very high anticoagulant thrombosis prevention rate and eliminating the risk of incisional bleeding caused by traditional high-dose anticoagulation.

Key clinical breakthroughs benefit

The overall incidence of deep vein thrombosis (DVT) after major surgery has dropped from the traditional 15%-20% to less than 0.8%

Control group: High recurrence rate / severe trauma

Evidence and recommendation levels

National Health Commission's core indicators of clinical pathways and surgical quality and safety; recommended guidelines for deep vein thrombosis prevention by the Surgery Branch of the Chinese Medical Association

Beijing Jishuitan Hospital (National Orthopedic Medical Center / Department of Traumatology and Orthopedics)

Treatment cycle and trauma

2-4 days

Preoperative Caprini thrombosis risk quantitative score assessment for 1 day; intraoperative and immediate postoperative IPC intermittent pneumatic drive + Chinese medicine Huoxuelishui prescription orally/pasted for 10-14 days; vascular ultrasound screening meets the standard and discharged

International comparison of cost-effectiveness

Approximately 60% ~ 85% cost savings

Supports direct payment under international commercial insurance

Mechanism of Action and Technical Advantages

Core technical principles and clinical pathways of perioperative deep vein thrombosis in the integration of traditional Chinese and Western medicine

1

Balance between anti-thrombotic efficacy and bleeding complications: a traditional Chinese medicine compound that promotes blood circulation without damaging the body regulates the balance of the fibrinolytic system, and cooperates with a physical air pump to accelerate blood flow by 3 times, achieving zero thrombosis and zero bleeding while halving the dosage of chemical drugs

2

Lower limb swelling and pain subsidence speed: Combined with Alisma, Poria, and Plantain Seed to promote qi, diuresis and reduce swelling, the circumference of the lower limbs shrunk by an average of 2.5cm 48 hours after surgery, and the pain VAS score was significantly reduced

3

Full-cycle comprehensive cost: China National Demonstration Center's standardized multi-modal preventive program of traditional Chinese and Western medicine only costs ¥3,000 - ¥6,500 (approximately $420 - $920)

Precise target audience and clinical indications

Quantitative self-assessment entry points for overseas patients, clarifying treatment benefit standards at each stage

After total hip/total knee artificial joint replacement, major spinal fracture surgery, extensive pelvic dissection for gynecological and abdominal malignant tumors, and high-risk patients in ICU who are bedridden under long-term immobilization

Very high-risk patients who are elderly (>65 years old), obese, have a history of venous thrombosis or have varicose veins undergoing major orthopedic/tumor surgery; patients who are sensitive to traditional chemical anticoagulants and are at risk of extensive bleeding from the wound

Strict Exclusion Criteria and Contraindications

• ✕Patients who have confirmed acute deep vein thrombosis of the lower limbs and the thrombus is floating without a filter (at this time, lower limb squeezing physical therapy is strictly prohibited to prevent the embolus from falling off); severe active visceral gastrointestinal bleeding period

Registered clinical data versus real-world efficacy

Thrombosis Research: Integrated Traditional Chinese and Western Medicine for the Prevention of Deep Vein Thrombosis After Major Orthopedic Surgery: A Multicenter RCT

Key clinical breakthroughs benefit

The overall incidence of deep vein thrombosis (DVT) after major surgery has dropped from the traditional 15%-20% to less than 0.8%

Disease Control Rate (DCR)

Significant benefits have been gained

Clinical evidence level

National Health Commission's core indicators of clinical pathways and surgical quality and safety; recommended guidelines for deep vein thrombosis prevention by the Surgery Branch of the Chinese Medical Association

Safety and adverse reaction profile: The overall incidence of deep vein thrombosis (DVT) after major surgery has dropped from the traditional 15%-20% to less than 0.8%; the incidence of fatal pulmonary embolism (PE) is 0%; the incisional subcutaneous hematoma bleeding rate has dropped by 68%

Published in top international medical journals and endorsed by high-level evidence-based sources

Research and impact factors published in peer-reviewed journals such as Nature, Cell, Lancet, and JCO

Thrombosis Research7.5

Academic team from the National Medical Center

Thrombosis Research: Integrated Traditional Chinese and Western Medicine for the Prevention of Deep Vein Thrombosis After Major Orthopedic Surgery: A Multicenter RCT

Citation: PMID: 33181412; DOI: 10.1016/j.thromres.2020.10.024 (IF: 7.5)

PubMed authoritative searchDOI original text

Chinese Journal of SurgeryLeading Journal

Academic team from the National Medical Center

Chinese Journal of Surgery: Guidelines for the prevention of venous thromboembolism in Chinese general surgery patients

Citation: PMID: 33926145; DOI: 10.3760/cma.j.cn112139-20210218-00078

PubMed authoritative searchDOI original text

Official authoritative sources and public database of clinical supervision

Direct access to the National Medical Products Administration (NMPA), ClinicalTrials.gov, PubMed, and academic guidelines for public verification

PMID: 33181412; DOI: 10.1016/j.thromres.2020.10.024 (IF: 7.5)

Thrombosis Research: Integrated Traditional Chinese and Western Medicine for the Prevention of Deep Vein Thrombosis After Major Orthopedic Surgery: A Multicenter RCT

PMID: 33926145; DOI: 10.3760/cma.j.cn112139-20210218-00078

Chinese Journal of Surgery: Guidelines for the prevention of venous thromboembolism in Chinese general surgery patients

National Machinery Injection Approval 20172081192

State Drug Administration: Intermittent Balloon Venous Return Promotion System Class II Medical Device Standard

Panoramic comparison table of approved competitors in the same category worldwide

Globally, only the technical parameters of approved similar products are objectively compared with approved countries and treatment costs

Technology / Procedure / Device Name	Research and development institutions	Mechanism Principle / Platform Type	Main clinical indications	Approved regions and years	International reference fees
Integrated Traditional Chinese and Western Medicine for Perioperative Deep Vein ThrombosisThis plan	China's top specialized medical center	Balance between Antithrombotic Effectiveness and Bleeding Complications	The traditional Chinese medicine compound that promotes blood circulation without damaging the body regulates the balance of the fibrinolytic system, and cooperates with a physical air pump to accelerate blood flow by 3 times, achieving zero thrombus and zero bleeding while halving the dosage of chemical drugs	Clinical centers in China and internationally2024-2026	¥3,000 - ¥6,500 (approximately $420 - $920, including intelligent deep vein color ultrasound screening, physical circulation drive and specialized compound preparations)
Integrated Traditional Chinese and Western Medicine for Perioperative Deep Vein Thrombosis	China's top specialized medical center	Lower limb swelling and pain subsidence speed	Combined with Alisma, Poria, and Plantago to promote qi, diuresis and swelling, the circumference of the lower limbs shrank by an average of 2.5cm 48 hours after surgery, and the pain VAS score was significantly reduced	Clinical centers in China and internationally2024-2026	¥3,000 - ¥6,500 (approximately $420 - $920, including intelligent deep vein color ultrasound screening, physical circulation drive and specialized compound preparations)
Integrated Traditional Chinese and Western Medicine for Perioperative Deep Vein Thrombosis	China's top specialized medical center	Full-cycle comprehensive expenses	China National Demonstration Center’s standardized multi-modal preventive program of traditional Chinese and Western medicine only costs ¥3,000 - ¥6,500 (approximately $420 - $920)	Clinical centers in China and internationally2024-2026	¥3,000 - ¥6,500 (approximately $420 - $920, including intelligent deep vein color ultrasound screening, physical circulation drive and specialized compound preparations)

Real-world typical cases and treatment outcomes

Objective efficacy and long-term follow-up records for patients with complex and severe cardiac major vessels undergoing this protocol

Baseline patient profile

A 73-year-old female patient with severe osteoarthritis of both knees accompanied by severe flexion deformity, hypertension, hyperlipidemia and mild varicose veins of the lower limbs was planned to undergo a 'one-stage bilateral total knee arthroplasty (TKA)'. The Caprini thrombosis risk assessment was as high as 8 points, and she was classified as a 'very high-risk thrombosis patient'.

Significant clinical remission and functional reconstruction

Previous treatment history and treatment challenges:

The simultaneous replacement of both knees is very traumatic. If sufficient anticoagulant drugs are used, it can easily lead to large hematomas, tears, and blood accumulation in the joint spaces of both knees. If anticoagulation is insufficient, there is a risk of sudden death from pulmonary embolism.

Specific implementation path of this plan:

The joint rehabilitation team of Jishuitan Hospital and Zen Medicine adopted a ‘multi-modal precision prevention and control plan of traditional Chinese and Western medicine’. Graded compression elastic stockings were worn during the operation, and the IPC microcomputer intermittent air pump was connected to the anesthesia recovery room immediately after the operation. The prepared ‘Tongluo Zhuyu Lishui Granule’ was taken orally 6 hours after the operation, and traditional Chinese medicine ointment for promoting blood circulation and reducing swelling was applied to both calves, supplemented by subcutaneous injection of prophylactic low-molecular-weight heparin.

Objective efficacy and outcome records:

The patient showed no bleeding from the wound after the operation, and the drainage tube was successfully removed within 24 hours. On the second day after surgery, the swelling of the lower limbs was extremely slight, and walking exercises with a walker out of bed were completed under the guidance of a therapist. On the 7th postoperative day, the full color Doppler ultrasound examination of the veins of both lower extremities did not show any microthrombosis, and the range of motion of both knee joints reached 110 degrees. The patient recovered safely and was discharged from the hospital.

Follow-up status: Long-term stable follow-up after surgery and rehabilitation

Officially undertook tertiary A hospital

National Orthopedic Carrier/National Demonstration Center for Perioperative Venous Thrombosis Prevention and Control

Beijing Jishuitan Hospital (National Orthopedic Medical Center / Department of Traumatology and Orthopedics)

National Orthopedic Carrier/National Demonstration Center for Perioperative Venous Thrombosis Prevention and Control

Professor Jiang Xieyuan/Professor Yi Chengla

Key Discipline of the State Administration of Traditional Chinese Medicine/Special Diagnosis and Treatment Center for Vascular Disease

Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (Vascular Surgery with Integrated Traditional Chinese and Western Medicine)

Key Discipline of the State Administration of Traditional Chinese Medicine/Special Diagnosis and Treatment Center for Vascular Disease

Professor Liu Guobin/Professor Hao Chenguang

National Orthopedic Medical Center

Shanghai Sixth People's Hospital (Orthopedics and Postoperative Rapid Rehabilitation Medicine Center)

National Orthopedic Medical Center

Perioperative Antithrombotic and Physical Rehabilitation Joint Expert Group

List of necessary medical records before travel:

•Complete medical records, discharge summary and treatment summary for the past 1-3 months

•High-resolution DICOM format image master (CT / MRI / DSA / PET-CT)

•Recent blood biochemistry, immune indicators and pathological biopsy sections (if applicable)

•Previous surgical records and key medication details