Intermittent Pneumatic Compression for Hemiparetic Stroke Patients

Application and Patient Selection

The American Heart Association recommends applying IPC devices to both legs in stroke patients with hemiparesis, not just the affected limb, as the evidence supports bilateral application for DVT prophylaxis in immobile stroke patients, regardless of whether weakness is unilateral 1, 2
IPC should be applied to both lower extremities in all immobile stroke patients, including those with unilateral hemiparesis, as both legs remain at risk for DVT development 1, 2
The International Journal of Stroke guidelines suggest that IPC be applied as soon as possible within the first 24 hours of admission to immobile stroke patients 1

The American College of Cardiology recommends not applying IPC devices to legs with confirmed DVT, dermatitis, leg ulcers, severe leg edema, severe peripheral vascular disease, gangrene, or recent vein ligation or grafting 2, 3
Daily assessment of skin integrity is necessary while IPC devices are in use, and monitoring for signs of DVT development, including pain, swelling, and warmth, is crucial 1, 3

The American Heart Association states that IPC reduces DVT risk by 35% (relative risk reduction 0.69, 95% CI 0.55-0.86) in immobile stroke patients, and may improve 6-month survival (HR 0.86, 95% CI 0.73-0.99, p=0.042) 2
IPC is preferred over graduated compression stockings alone for post-stroke VTE prophylaxis, and can be used in addition to routine care and does not preclude pharmacological prophylaxis when appropriate 1, 2