The Specialty Hospital, Amman, Jordan, is the first hospital in the MENA region to start using the gekotm – an innovative neuromuscular electrostimulation device to prevent venous thromboembolism (VTE) in high-risk vascular patients who are unable to be prescribed standard of care.
VTE is a serious complication for patients in vascular care unitsand a preventable cause of hospital deaths worldwide [1].The current standard of care for VTE prevention, when blood thinners cannot be prescribed, due to risk of bleeding, is a boot-like cuff that compresses the leg to increase blood flow, called intermittent pneumatic compression (IPC). IPC, however, is not suitable for all patients due to vascular disease, fragile skin, or complex limb injury. This has resulted in the need for an alternative mechanical intervention when IPC is impractical or unavailable.
To address this unmet need, Dr. Walid Mohammed Hasan Masoud, senior consultant in vascular, endovascular and kidney transplant surgery at the Specialty Hospital, is using the geko device in the vascular department in an effort to prevent blood clots in high-risk patients.
He explained: “VTE is a complicating factor in the recovery of many critically ill patients within the vascular department setting; and for those unable to be prescribed drugs or IPC prophylaxis there is a real danger of serious, sometimes fatal, blood clotting. My team was therefore keen to find an alternative mechanical intervention to ensure that all patients can receive appropriate VTE prophylaxis when standard of care cannot be prescribed.
“We welcomed the opportunity to examine the role of the innovate geko device in our vascular care population. Our findings show the geko device is safe and well-tolerated and can be used to protect patients until it is safe to prescribe blood-thinning drugs.”
Painless electrical pulses
The small watch-sized device is attached to the side of the knee and produces painless electrical pulses, which increases blood flow in the deep veins of the calf [2] – equivalent to a rate of 60 percent of what would be produced while walking [3], without the patient having to move. The device prevents blood stasis in the deep veins of the calf by activation of foot and calf muscle pumps via stimulation of the common peroneal nerve. The battery-powered geko weighs just 10g and is silent in operation. It is self-adhesive and comfortable to wear.
Looking at data, reporting a zero VTE incidence in immobile acute stroke patients [4], Dr Masoud saw the potential of the geko device for blood clot prevention in immobile, high-risk vascular patients.
Now in routine use in the unit, Dr. Masoud is looking at the potential of using the neuromuscular electrostimulation device to address other areas of unmet need at the Speciality Hospital, including complications related to swelling after surgery and hard-to-heal chronic wounds.
- For more information, visit: www.gekodevices.com
References
[1] Geerts WH, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;1336 Suppl:381s–453s.
[2] A.Nicolaides, M Griffin. Measurement of blood flow in the deep veins of the lower limb using the geko™ neuromuscular electro-stimulation device. Journal of International Angiology August 2016-04. PMID: 26934561
[3] Tucker A, et al. Augmentation of venous, arterial and microvascular blood supply in the leg by isometric neuromuscular stimulation via the peroneal nerve. The International journal of angiology: official publication of the International College of Angiology, Inc. 2010 Spring; 19(1): e31-7. doi: 10.1055/s-0031-1278361
[4] Natarajan I, et al. Poster: The use of the geko™ device and the activation of the foot and calf pumps for prevention of venous thromboembolism in patients with acute stroke. Data on file Firstkind Ltd 2019.
