Prevention and management of venous thromboembolism in the surgical patient: options by surgery type and individual patient risk factors.

Abstract:

BACKGROUND:Current evidence-based guidelines provide recommendations for prophylaxis and treatment of venous thromboembolism (VTE) in a variety of surgical patients. DATA SOURCES:A systematic Ovid Medline search (from 1950 to the present) was conducted for relevant articles using the following search terms: "venous thromboembolism," "thrombophlebitis," "thromboembolism," "pulmonary embolism," "heparin," "low-molecular-weight heparin," "postoperative complications," and "anticoagulants." CONCLUSIONS:Pharmacologic and mechanical approaches are available for VTE prophylaxis, including low-dose unfractionated heparin, low-molecular-weight heparin, vitamin K antagonists, fondaparinux, intermittent pneumatic compression devices, and graduated compression stockings. Permanent inferior vena cava filters are not recommended for primary VTE prophylaxis, although they do have a role in the prevention of pulmonary embolism in patients with recent VTE who cannot have surgery delayed. Retrievable inferior vena cava filters are under investigation for primary VTE prophylaxis in trauma patients. New anticoagulants that inhibit factor Xa and thrombin will soon be available for the prevention and treatment of VTE in surgical patients.

journal_name

Am J Surg

authors

Muntz JE,Michota FA

doi

10.1016/j.amjsurg.2009.10.007

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

S11-20

issue

1 Suppl

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(09)00646-1

journal_volume

199

pub_type

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