27 Jun VTE in acute stroke patients can be prevented using the geko™ device
In honour of National Thrombosis Week 2022 (NTW22), Dr Indira Natarajan – Stroke Physician at Royal Stoke University Hospital, a clinical partner of Sky – detailed the effectiveness and advantages of adopting the geko™ device as an alternative prophylaxis for VTE prevention. The presentation was delivered as part of the NTW22 annual meeting to an audience of healthcare professionals (HCPs).
Opening the talk, Dr Natarajan described the geko™ device anti-stasis mechanism of action, in that it gently stimulates the common peroneal nerve, activating the calf and foot muscle pumps, resulting in an increased flow of blood in the deep veins of the calf – at a rate equal to 60 percent of walking without the patient having to move.
Identifying the risk
Dr Natarajan also discussed NICE Guidelines (NG89) that recommends intermittent pneumatic compression (IPC), a boot-like cuff that compresses the legs to move blood, as the primary method of mechanical VTE prevention. However, IPC is not suitable for all patients due to vascular disease and fragile skin – findings that are supported in the CLOTS3 study reports 30 percent of patients are immediately contraindicated or become intolerant to IPC – exposing these patients to a VTE risk of up to 8.7 percent where no prophylaxis is provided.
This represented a significant unmet need – one which Dr Natarajan and his team at Royal Stoke Hospital addressed with the findings of a real-word audit of clinical practice. The contraindication and/or intolerance to IPC of 1,000 immobile, hyper-acute stroke patients were reviewed and quantified. The results showed 68.8 percent of patients were in need of IPC but 29.5 percent of the cohort were either contraindicated or were unable to tolerate IPC, matching the findings of the CLOTS3 study. This revealed a significant unmet need for an alternative anti-stasis (blood clot prevention) intervention. Dr Natarajan explained it was to this cohort the geko™ device was fitted.
The study measured VTE events at 90 days post-stroke. The data shows that of the patients treated with IPC alone, as the standard of care, 2.4 percent suffered a VTE event, compared to a zero percent incidence of VTE in patients prescribed the geko™ device alone. Patients prescribed the device also showed no adverse events and reported a greater tolerance of the geko™ device compared to IPC.
Paving the way for change with Thrombosis UK
One in four deaths are a result of thrombosis-related events, killing more people than car crashes, cancer and AIDS combined. Thrombosis is also the leading cause of preventable hospital deaths.
National Thrombosis Week, hosted by Thrombosis UK, is an annual event where patients, HCPs and organisations join forces to raise awareness of thrombosis and the risk factors associated with the condition. Various clinicians hosted sessions to educate fellow HCPs on the importance of blood clot prevention and embracing innovation for better patient outcomes. As Dr Natarajan states: ‘when you’re in the process of innovation, you have to first identify the need for change’.
Watch Dr Natarajan’s symposium on the geko™ device in VTE prevention on the Thrombosis UK website now: https://thrombosisuk.org/training-resources.php