Deep venous thrombosis in postoperative vascular surgical patients: A frequent finding without prophylaxis

Hollyoak, Maureen; Woodruff, Peter; Müller, Michael; Daunt, Nicholas; Weir, Paula

doi:10.1067/mva.2001.116803

Cited by 45 publications

(28 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1 The rates of DVT after aortoiliac or aortofemoral surgery are similar to those seen in other types of abdominal and pelvic procedures. 22 In the absence of prophylaxis, the rate of DVT is Ϸ21% when routine contrast venography is obtained [23][24][25] and 15% when routine postoperative ultrasonography is performed. 22,26 Patients undergoing major vascular procedures who have additional thromboembolic risk factors should receive antithrombotic prophylaxis with LDUH or LMWH.…”

Section: Vascular Surgerymentioning

confidence: 99%

“…22 In the absence of prophylaxis, the rate of DVT is Ϸ21% when routine contrast venography is obtained [23][24][25] and 15% when routine postoperative ultrasonography is performed. 22,26 Patients undergoing major vascular procedures who have additional thromboembolic risk factors should receive antithrombotic prophylaxis with LDUH or LMWH. Although the optimal time to start prophylaxis with antithrombotic agents in patients undergoing vascular surgery remains unclear, some practitioners prefer to administer the first dose after surgery.…”

Section: Vascular Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Prevention of Venous Thromboembolism in Surgical Patients

2004

View full text Add to dashboard Cite

Abstract-Venous thromboembolism (VTE) is a common complication of surgical procedures. The risk for VTE in surgical patients is determined by the combination of individual predisposing factors and the specific type of surgery. Prophylaxis with mechanical and pharmacological methods has been shown to be effective and safe in most types of surgery and should be routinely implemented. For patients undergoing general, gynecologic, vascular, and major urologic surgery, low-dose unfractionated heparin or low-molecular-weight heparin (LMWH) are the options of choice. For low-risk urologic surgery, early postoperative mobilization of patients is the only intervention warranted. For higher-risk patients, including those undergoing elective hip or knee replacement and surgery for hip fracture, vitamin K antagonists, LMWH, or fondaparinux are recommended. For patients undergoing neurosurgery, graduated elastic stockings are effective and safe and may be combined with LMWH to further reduce the risk of VTE. The role of prophylaxis is less defined in patients undergoing elective spine surgery, as well as laparoscopic and arthroscopic surgery. A number of issues related to prophylaxis of VTE after surgery deserve further clarification, including the role of screening for asymptomatic deep vein thrombosis, the best timing for initiation of pharmacological prophylaxis, and the optimal duration of prophylaxis in high-risk patients. Key Words: venous thromboembolism Ⅲ deep vein thrombosis Ⅲ pulmonary embolism Ⅲ heparin Ⅲ low-molecular-weight heparin Ⅲ vitamin K antagonists

show abstract

Section: Vascular Surgerymentioning

confidence: 99%

Section: Vascular Surgerymentioning

confidence: 99%

Prevention of Venous Thromboembolism in Surgical Patients

2004

View full text Add to dashboard Cite

show abstract

“…Hollyoak, in turn, did not observe new thrombus forming in patients with residual thrombus in lower limb veins [28]. However, it would be inappropriate to draw any conclusions from this fact, as the old post-thrombotic lesions were found in one patient only.…”

Section: Tc -Thromboembolic Complicationsmentioning

confidence: 88%

“…In the research study done by Hollyoak, thrombosis in 80% pertained to the peripheral veins, and in 20% -the veins of the femoropopliteal segment [28]. In other studies the above ratio moved gradually in the proximal direction, amounting to, respectively, for the distal and proximal section, 78% and 22% [21], 67% and 33% [22], and 52% and 48% [29].…”

Section: Discussionmentioning

confidence: 99%

Thromboembolic complications in patients using pharmacological antithrombotic prophylaxis and operated on for arterial occlusive disease in the aorto-iliac segment

Pawlaczyk-Gabriel¹,

Gabriel²,

Leszek³

et al. 2014

View full text Add to dashboard Cite

Objectives: This prospective, non-randomised study was aimed at the assessment of prevalence of thromboembolic events in vascular patients routinely receiving antithrombotic prophylaxis following surgical revascularisation of the lower extremities. Material and methods: This study included 105 patients operated on for aortoiliac occlusive disease. Postoperatively all patients received pharmacological antithrombotic prophylaxis with low-molecular-weight heparin. Sonographic examination of the veins of low extremities was routinely performed three times: one day before the surgery, on the discharge day and 30 days after hospital discharge. Results: Thromboembolic complications were found in 21 patients (19.05%), including 18 patients with deep venous thrombosis and 3 with pulmonary embolism. Thromboembolic events were more prevalent in older patients (68.22 vs. 62.65 years), those with necrotic lesions of the limbs, with lower preoperative concentration of hemoglobin (7.89 vs. 8.61 mmol/l), higher of fibrinogen (455 vs. 357 mg/dl) and of platelet count (334 vs. 250 × 10 9 /l). Other risk factor comprised the number of transfused packed red blood cell units (3.39 vs. 1.45 units) and plasma units (1.61 vs. 0.39 units), and the length of stay in the intensive care unit (4.78 vs. 2.24 days). Conclusions: Vascular patients develop thromboembolism very often, despite pharmacological prophylaxis. Thus, routine scanning for deep vein thrombosis before hospital discharge in order to exclude thrombosis should be considered in this group. Also, an extended post-discharge thromboprophylaxis in these patients should be considered.

show abstract

“…A trombose venosa profunda (TVP) é uma doença de ocorrência multidisciplinar, caracterizada pela formação de trombos de forma oclusiva total ou parcial, em veias do sistema venoso profundo, e freqüentemente relacionada a diversos fatores de riscos, que podem promover seu aparecimento súbito em pacientes hígi-dos ou como complicação clínica e/ou cirúrgica [1][2][3][4][5] .…”

Section: Palavras-chaveunclassified

Profilaxia para tromboembolismo venoso em um hospital de ensino

et al. 2006

View full text Add to dashboard Cite

Objective: To verify whether deep venous thrombosis prophylaxis is being correctly and routinely used at a teaching hospital.Methods: A cross-sectional study of hospitalized patients on seven sectors at Conjunto Hospitalar de Sorocaba (Hospital de Ensino) was performed from August 2004 to August 2005. For the deep venous thrombosis risk stratification of each patient, clinical and surgical factors were investigated, according to the protocol recommended by Sociedade Brasileira de Angiologia e de Cirurgia Vascular. During the period, 216 medical charts were analyzed. Of these, 30 were from abdominal surgery, 30 from vascular surgery, 30 from urology, 31 from medical clinic, 31 from intensive care unit, 31 from orthopedics and 33 from obstetrics/gynecology.Results: Out of the total number of patients, deep venous thrombosis prophylaxis was performed in 57 (26%), considering that in 51 (89%) the procedure was correct and in six (11%) it did not follow the standard. The most used type of prophylaxis was drug treatment; 49 out of 57 patients used low-molecular-weight heparin. We also observed the use of elastic socks in five patients and early ambulation in seven. On the other hand, intermittent pneumatic compression was not used for any patient.Conclusion: According to the results and based on the protocol, we concluded that, during the period of the research, deep venous thrombosis prophylaxis, at Conjunto Hospitalar de Sorocaba, was routinely and correctly performed in only 23.6% of the patients (51 out of 216).Key words: Deep venous thrombosis, prophylaxis, thromboembolism. ResumoObjetivo: Verificar se a profilaxia da trombose venosa profunda está sendo utilizada de maneira correta e rotineira em um hospital de ensino. Resultados: Do total de pacientes, foi efetuada profilaxia para trombose venosa profunda em 57 (26%), sendo que, em 51 (89%), a execução foi de maneira correta e, em 6 (11%), não-preconizada. O método profilático mais utilizado foi o medicamentoso; 49 de 57 pacientes fizeram uso de heparina de baixo peso molecular. Também foi verificada a utilização de meias elásticas em cinco pacientes e deambulação precoce em sete. Já a compressão pneumática intermitente não foi utilizada em nenhum deles. Métodos e casuística: Foi realizado um estudo transversal de pacientes internados em sete setores (enfermarias) do ConjuntoConclusão: De acordo com os resultados e com base no protocolo, concluiu-se que, no período da pesquisa, a profilaxia para trombose venosa profunda, no Conjunto Hospitalar de Sorocaba, foi executada rotineiramente e de forma adequada em apenas 23,6% (51 do total de 216 pacientes). Palavras-chave:Trombose venosa profunda, profilaxia, tromboembolismo.ARTIGO ORIGINAL

show abstract

Deep venous thrombosis in postoperative vascular surgical patients: A frequent finding without prophylaxis

Abstract: The incidence of postoperative lower-limb DVTs in this cohort of vascular surgical patients was high. The small size of the study population precludes generalized recommendations, but the results indicate an urgent need for definitive investigation.

Cited by 45 publications

References 25 publications

Prevention of Venous Thromboembolism in Surgical Patients

Prevention of Venous Thromboembolism in Surgical Patients

Thromboembolic complications in patients using pharmacological antithrombotic prophylaxis and operated on for arterial occlusive disease in the aorto-iliac segment

Profilaxia para tromboembolismo venoso em um hospital de ensino

Contact Info

Product

Resources

About