Graduated compression stockings (GCS) are routinely prescribed for deep vein
thrombosis (DVT) prophylaxis in acute stroke patients. In the light of recent data from
the CLOTS trial 1, this practice needs to be reviewed.
This article presents an evidence based review of the literature regarding the use of GCS
for DVT prevention in acute stroke patients.
Data on the use of GCS for DVT prevention in acute stroke is limited. The CLOTS trial 1
provides strong evidence that the routine use of GCS in acute stroke patients does not
significantly reduce the risk of DVT and that GCS increase the risk of skin problems in
this population. Graduated compression stockings may also increase the risk of critical
limb ischaemia and are contraindicated in patients with known peripheral vascular
disease, or an ankle brachial pressure index <0.8. Graduated compression stockings
may help reduce dependant oedema in stroke patients with reduced mobility, although
there have been no studies looking at this question in stroke patients. Graduated
compression stockings should not be routinely prescribed for acute stroke patients. The
decision to use GCS in acute stroke patients should be individualised.
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