Image: The Covidien Kendall SCD system with vascular refill detection technology (Photo courtesy of Covidien).
A new study shows that intermittent pneumatic compression (IPC) can reduce deep vein thrombosis (DVT) incidents in immobile stroke patients.
Researchers at the University of Edinburgh (United Kingdom) reported the results of the CLOTS 3 study, a multicenter, randomized, controlled study that enrolled 2,876 patients within the first 3 days of their admission to 105 hospitals in the UK between 2008 and 2012. The patients were randomized to best medical care or best medical care plus IPC. DVT was detected using a compression duplex ultrasound scan at about 7-10 days and 25-30 days. The primary outcomes included symptomatic or asymptomatic DVT in the popliteal or femoral veins.
The results of the study showed a 29.9% decrease in the development of proximal DVT in immobile stroke patients, compared to the routine care group only. The patients received IPC treatment via the Kendall SCD system, a product of Covidien (Dublin, Ireland), which uses vascular refill detection technology to deliver sequential, circumferential, gradient compression through thigh-length sleeves. The results also showed an overall 14% mortality risk reduction during the first six months after hospital admission for stroke. The results of the study were presented at the European Stroke Conference, held during May 2013 in London (United Kingdom).
“At last we have a simple, safe, and affordable treatment that reduces the risk of DVT and even appears to reduce the risk of dying after a stroke,” said lead author Prof. Martin Dennis, MD, of the division of clinical neurosciences. “We believe that the national guidelines need to be revised in the light of our findings; the current guidelines have suggested that IPC should be considered only where blood thinning injections are unsuccessful or inappropriate, but this research suggests that IPC should be used in all patients at high risk of DVT.”
IPC uses a pair of inflatable sleeves wrapped around the legs and attached via flexible tubing to a small bedside electric pump. The sleeves may be short (or below knee), wrapping around the calves, or long (thigh length); they are inflated one side at a time to compress the legs at intervals. Some types inflate sequentially, first around the lower leg and then the upper, "milking" the blood from the leg to increase venous flow. IPC is thought to reduce the risk of DVT by increasing the flow of venous blood through the veins and by stimulating release of intrinsic fibrinolytic substances.
University of Edinburgh