College of Medicine & Veterinary Medicine

Hope for stroke patients

Stroke patients at risk of blood clots and death could be helped by a compression device that wraps around the legs.

Researchers have shown for the first time that by gently squeezing the legs, the risk of dying after stroke is reduced.

It is thought that the compression reduces the risk of clots in the veins of the legs by increasing blood flow.

The results of the trial, published in The Lancet, reveal that thigh-length intermittent pneumatic compression (IPC) reduces the risk of deep vein thrombosis (DVT), which commonly affects stroke patients.

Until now, no treatment has been available that safely reduces the risk of the blood clots in the legs and the risk of dying.

At last we have a simple, safe and affordable treatment that reduces the risk of DVT and even appears to reduce the risk of dying after a stroke. We estimate that this treatment could potentially help about 60,000 stroke patients each year in the UK.

Professor Martin DennisDivision of Clinical Neurosciences

Trialling success

More than 2800 stroke patients across the UK were involved in the randomised trial, which took place between 2008 and 2012.

Hundreds of researchers from more than 100 hospitals took part.

The IPC sleeves, which cost the NHS as little as £25 per pair, can be worn for several days or weeks after the stroke.

They are inflated for a few seconds, one leg at a time, to compress the veins in the legs every minute or so.

The trial was funded by The National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme and the Chief Scientist Office Scotland.

Stroke threat

Stroke is the second most common cause of death worldwide.

Around 15 million people have a stroke each year worldwide - one third of whom will die. Another third will become permanently disabled.

DVT can lead to pulmonary embolism, which blocks patients’ blood vessels in their lungs and can cause heart failure, killing thousands of people each year.

Stroke patients most at risk of DVT include those with weakness of their arms and legs, who are unable to walk on admission to hospital.

Some 20 per cent of these people will go on to develop a blood clot in the veins in their legs.

Improving treatment

Current treatments include blood thinning injections, which have been shown to reduce the risk of DVT.

However, these carry an increased risk of bleeding - a serious drawback for stroke patients because of the threat of bleeding into the brain.

Experts also add that blood thinning injections have not been conclusively shown to reduce the risk of dying after stroke.

Finding a way of preventing blood clots from developing in the legs after stroke has been a huge challenge with all the research up until now failing to identify a safe and effective treatment to this common and dangerous complication. This study is a major breakthrough showing how a simple and safe treatment can save lives. It is one of the most important research studies to emerge from the field of stroke in recent years.

Professor Tony RuddChair of the Intercollegiate Stroke Guideline Group at the Royal College of Physicians