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DVT Prevention - Stroke

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Serving an unmet need in high-risk acute stroke patients

The risk of venous thromboembolism (VTE) after stroke is increased in patients with restricted mobility and an abnormal tendency for blood to clot after a stroke1. Current strategies for managing VTE risk in immobile stroke patients are:

  • Intermittent Pneumatic Compression (IPC)
  • Prophylactic-dose of Low Molecular Weight Heparin (LMWH), when bleed risk reduces 

 

Patients who are contraindicated or become intolerant to IPC have a 6.3% increased risk of developing a symptomatic DVT. The CLOTS 3 study suggests a significant level of unmet need in this patient group. 

Firstkind has worked with The University Hospital of North Midlands NHS Trust to introduce the geko™ device into the stroke pathway when patients are unsuitable for drug prophylaxis and/or contraindicated to IPC. The use of the geko™ device has been assessed through a prospective patient audit of clinical practice, covering patients who have been admitted for either ischemic or haemorrhagic stroke. Patients unsuitable for VTE drug prophylaxis or contraindicated to IPC were given the geko™ device. 

Interim analysis highlights that the majority of high risk immobile acute stroke patients who could not tolerate IPC tolerated the geko™ device. These patients would have not been treated as effectively otherwise, with the potential that geko™ will reduce the risk of morbidity and mortality in stroke patients. The geko™ device was well tolerated and easy to use throughout the study.

Health economic analysis shows that using the geko™ device for this group of patients saves the NHS £36 (on average) per patient compared to no prophylaxis.  

 

References:

1. L. Jaap Kappelle, Preventing Deep Vein Thrombosis After Stroke: Strategies and Recommendations. Curr Treat Options Neurol. 2011

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