http://www.strokeupdate.co.uk Medical Blog relating to Stroke Medicine for Patients and Doctors Fri, 09 Dec 2011 18:53:15 +0000 en hourly 1 http://wordpress.org/?v=3.0.4 http://www.strokeupdate.co.uk/2009/07/graduated-compression-stockings-and-risk-of-venous-thrombosis-following-stroke-clots-trial1/ http://www.strokeupdate.co.uk/2009/07/graduated-compression-stockings-and-risk-of-venous-thrombosis-following-stroke-clots-trial1/#comments Sat, 18 Jul 2009 20:18:30 +0000 amer http://www.d1037909.cp.blacknight.com/stroke/?p=90 ]]> Stroke care teams all over the world were looking with interest to the results of Clots Trial 1. It has been reported in medical literature that graduated compression stockings GCS might help in reducing the risk of the deep venous thrombosis (DVT) and the risk of pulmonary embolism (PE) in surgical patients. This notion led to the hypothesis that this type of stockings might be useful in reducing the risk of DVT and PE in ischaemic stroke patients.
In this outcome-blinded, randomised controlled trial (The lancet 2009;373: 9679; 1958-1965), 2518 patients who were admitted to hospital within 1 week of an acute stroke and who were immobile were enrolled from 64 centres in the UK, Italy, and Australia. Patients were allocated via a central randomisation system to routine care plus thigh-length GCS (n=1256) or to routine care plus avoidance of GCS (n=1262).
A technician who was blinded to treatment allocation undertook compression Doppler ultrasound of both legs at about 7—10 days and, when practical, again at 25—30 days after enrolment. The primary outcome was the occurrence of symptomatic or asymptomatic DVT in the popliteal or femoral veins. Analyses were by intention to treat.
All patients were included in the analyses. The primary outcome occurred in 126 (10•0%) patients allocated to thigh-length GCS and in 133 (10•5%) allocated to avoid GCS, resulting in a non-significant absolute reduction in risk of 0•5%. Skin breaks, ulcers, blisters, and skin necrosis were significantly more common in patients allocated to GCS than in those allocated to avoid their use.
The study concluded that The data from Clots Trial 1 do not lend support to the use of thigh-length GCS in patients admitted to hospital with acute stroke. The time is right now to revise the national guidelines for stroke on the basis of these results.

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