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Thigh-length compression stocking did not reduce VTE after stroke
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The use of thigh-length graduated compression stockings did not reduce the occurrence of symptomatic or asymptomatic deep vein thrombosis when used after stroke, according to the results of the CLOTS 1 trial.
“Indeed, [graduated compression stockings] damage the skin and might promote limb ischemia,” Philip M. W. Bath, MD, and Timothy J. England, MD,of the Stroke Trials Unit Institute of Neuroscience at the University of Nottingham, U.K., wrote in an accompanying editorial. “Graduated compression stockings should not be used after stroke and current guidelines will need to be amended.”
They also added that the use of graduated compression stockings in other settings should be “urgently” assessed to determine their efficacy.
The CLOTS 1 trial was a 64-center, outcome-blinded, randomized, controlled trial. Researchers enrolled 2,518 patients who were admitted to the hospital within one week of an acute stroke and who were immobile. They randomly assigned patients to routine care plus a thigh-length graduated compression stocking or to routine care alone.
Ten percent of patients assigned to wear a stocking had a symptomatic or asymptomatic DVT in the popliteal or femoral veins as detected by Doppler ultrasound compared with 10.5% of those without a stocking.
In addition, those patients with a stocking also had significantly more frequent skin breaks, ulcers, blisters and skin necrosis than those patients who did not use a stocking (5% vs. 1%).
For more information:
- CLOTS Trials Collaboration. Lancet. 2009;373:1958-1965.