[Mechanical prophylaxis of venous thromboembolism].

Mechanical devices for the prevention of venous thromboembolism (VTE) act on venous stasis and include static systems: the graduated compression stockings (or elastic stockings or anti-embolism stockings) and dynamical systems: intermittent pneumatic compression and venous foot pump. The main advantage of these devices is that they have no risk of bleeding. If the prevention of VTE is based primarily on drug prophylaxis, mechanical devices are recommended primarily for patients with high risk of bleeding, if there is contraindication to anticoagulants. Alone or in combination with drug prophylaxis, their efficacy on deep vein thrombosis prevention is well documented in surgery, but the evidence is insufficient for the prevention of pulmonary embolism and in other settings. Their interest in stroke is called into question after the results of the CLOTS 1 and 2 studies. These results, beyond the context of stroke, have raised numerous questions about the real benefit/risk ratio of mechanical devices for the prevention of VTE. They highlight the need to assess or re-evaluate mechanical devices by rigorous clinical trials.