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DVT in acute stroke--the use of graduated compression stockings.

BACKGROUND
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.


OBJECTIVE
This article presents an evidence based review of the literature regarding the use of GCS for DVT prevention in acute stroke patients.


DISCUSSION
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.