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    Tuesday, July 21, 2009

    Pressure Stockings 'Should Not Be Used' to Prevent DVT

    Deep vein thrombosis (DVT) and pulmonary embolism are common after stroke. In small trials of patients undergoing surgery, graduated compression stockings (GCS) appear to reduce the risk of DVT.

    National stroke guidelines in several countries extrapolating from these trials recommend their use in patients with stroke. Researchers assessed the effectiveness of thigh-length GCS to reduce DVT after stroke.

    In an international trial, researchers randomized some 2500 immobile patients hospitalized within 1 week of an acute stroke to either use of, or avoidance of, thigh-length stockings. Ultrasound studies done at roughly 30 days found no significant difference between the groups with regard to the occurrence of DVT in the popliteal or femoral vessels.

    However, the risk for adverse effects (skin breaks, ulcers, blisters, and necrosis) was much higher in stocking users than nonusers (5% vs. 1%).
    Graduated compression stockings don't reduce the risk for deep venous thrombosis after stroke, according to this large trial. Commentators say flatly that the stockings "should not be used after stroke and current guidelines will need to be amended."

    The Lancet, Online Publication, 2009 doi:10.1016/S0140-6736(09)60941-7

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