The medical technology guidance supports the geko device being used in people who have a high risk of venous thromboembolism (VTE), where standard methods of preventing blood clots aren’t suitable or can’t be used. 

Some patients are at high risk of VTE but they have conditions such as peripheral arterial disease  or dermatitis, which means that they would not be able to use the anti-embolism stockings commonly given to prevent blood clots. Where drugs to prevent clots also can’t be used, the geko device provides an option for patients who would otherwise be unable to receive treatment to reduce risk of blood clots in the leg. Using the device in this situation where no standard alternatives are available is likely to reduce the high risk of VTE and so is estimated to save nearly £200 per patient compared with no preventative treatment.

Professor Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: “This guidance is good news for patients at high risk of deep vein blood clots in the leg who can’t use standard prevention methods.  The Medical Technologies Advisory Committee decided that although the clinical evidence is limited, it was plausible that the geko device may reduce the high risk of VTE in patients who can’t use other forms of blood clot prevention. The additional low risk of the device causing any harm resulted in the guidance supporting routine NHS use of the device for patients at high VTE risk who have no preventative options. Using the device in this way is estimated to save £197 per patient. This guidance encourages the NHS to consider using the geko device for patients at high VTE risk where other methods of risk reduction aren’t suitable.”

If a blood clot blocks a vein deep in the body, this is commonly known as a deep vein thrombosis (DVT).  If a blood clot breaks away it may travel to the lungs and cause a blockage there – a potentially fatal pulmonary embolism.  VTE covers both deep vein thrombosis (DVT) and its possible consequence, pulmonary embolism.

The geko device is similar in size and appearance to a small wristwatch, and is fixed to the back of the knee joint via its adhesive surface.  The disposable, battery-powered device creates electrical impulses to stimulate a nerve in the leg, causing muscles to contract and so increasing the blood flow in the veins. This imitates the changes in blood flow normally achieved by walking, but without the person having to move. 

The claimed benefits of the geko device in the case for adoption presented by the device manufacturer include reducing the risk of VTE by preventing and reducing slow blood flow in the veins, the device being discreet and comfortable to wear allowing the person to remain mobile, and providing an alternative means of VTE risk reduction for patients who can’t use standard methods.

Ends

For more information call the NICE press office on 0845 003 7782 or out of hours on 07775 583 813.

Notes to Editors

About the NICE guidance

1. The geko device is manufactured by (FirstKind Ltd). 
2. The list price stated in the sponsor’s submission is £22 (excluding VAT) per pair of geko devices. 
3. Background on how blood clots occur: The blood’s clotting mechanism can go wrong, and a blood clot can form when there has been no injury. When this happens the blood clot is called a thrombus, and if it’s deep inside one of the veins in the body, most commonly in the leg, it is called deep vein thrombosis (DVT). If the blood clot comes loose it can travel through the bloodstream to the lungs - this is called pulmonary embolism and it can be fatal. DVT and pulmonary embolism together are known as venous thromboembolism. DVT is more likely to happen when someone is unwell and inactive or less active than usual. In this case blood may become temporarily ‘sticky’ and flow more slowly, which makes it more likely that a blood clot can form inside a vein. 
4. Standard methods of VTE prevention include blood-thinning drugs such as heparin, anti-embolism stockings and foot impulse or pneumatic devices. 

About the Medical Technologies Evaluation Programme

Established by NICE in 2009, the focus of this area of work is specifically on the evaluation of innovative medical technologies, including devices and diagnostics. The types of products which might be included are medical devices that deliver treatment such as those implanted during surgical procedures, technologies that give greater independence to patients, and diagnostic devices or tests used to detect or monitor medical conditions. The independent Medical Technology Advisory Committee has two core remits: selecting medical technologies for evaluation by NICE guidance programmes and also developing medical technologies guidance itself. The guidance applies to the NHS in England, and is not mandatory.