The American Journal of Surgery
Volume 199, Issue 1, Supplement , Pages S11-S20 , January 2010

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

  • James E. Muntz, M.D.

      Affiliations

    • Baylor College of Medicine, Houston, TX, USA
    • Memorial Hermann Sports Medicine Institute, University of Texas Health Center, Houston, TX, USA
    • Corresponding Author InformationCorresponding author. Tel.: 1+713-795-4847; fax: 1+713-795-0774
    • ,
  • Franklin A. Michota, M.D.

      Affiliations

    • Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
    • Department of Hospital Medicine, Cleveland Clinic, Cleveland, OH, USA

Received 23 July 2009 ,Revised 27 October 2009

References 

  1. Lyman GH, Khorana AA, Falanga A, et al. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol. 2007;25:5490–5505
  2. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: venous thromboembolic disease (V.1.2008). http://www.nccn.org/professionals/physician_gls/PDF/vte.pdfAccessed on January 5, 2009
  3. Snow V, Qaseem A, Barry P, et al. Management of venous thromboembolism: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2007;146:204–210
  4. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Guidelines Committee. Guidelines for deep venous thrombosis prophylaxis during laparoscopic surgery. Surg Endosc. 2007;21:1007–1009
  5. Johanson NA, Lachiewicz PF, Lieberman JR, et al. Prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty. J Am Acad Orthop Surg. 2009;17:183–196
  6. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008;133:381S–453S
  7. Lowinger JS, Maxwell DJ. Heparins for venous thromboembolism prophylaxis—safety issues. Aust Prescr. 2009;32:108–112
  8. Falanga A, Zacharski L. Deep vein thrombosis in cancer: the scale of the problem and approaches to management. Ann Oncol. 2005;16:696–701
  9. Kakkar AK, Levine M, Pinedo HM, et al. Venous thrombosis in cancer patients: insights from the FRONTLINE survey. Oncologist. 2003;8:381–388
  10. Rogers FB, Cipolle MD, Velmahos G, et al. Practice management guidelines for the prevention of venous thromboembolism in trauma patients: the EAST Practice Management Guidelines Work Group. J Trauma. 2002;53:142–164
  11. Gorman PH, Qadri SF, Rao-Patel A. Prophylactic inferior vena cava (IVC) filter placement may increase the relative risk of deep venous thrombosis after acute spinal cord injury. J Trauma. 2009;66:707–712
  12. Rosenthal D, Kochupura PV, Wellons ED, et al. Günther Tulip and Celect IVC filters in multiple-trauma patients. J Endovasc Ther. 2009;16:494–499
  13. Imberti D, Bianchi M, Farina A, et al. Clinical experience with retrievable vena cava filters: results of a prospective observational multicenter study. J Thromb Haemost. 2005;3:1370–1375
  14. Morris CS, Rogers FB, Najarian KE, et al. Current trends in vena caval filtration with the introduction of a retrievable filter at a level I trauma center. J Trauma. 2004;57:32–36
  15. Frederiksen SG, Hedenbro JL, Norgren L. Enoxaparin effect depends on body-weight and current doses may be inadequate in obese patients. Br J Surg. 2003;90:547–548
  16. Lovenox [package insert]. Bridgewater, New Jersey: Sanofi-Aventis; 2008;
  17. Michota F, Merli G. Anticoagulation in special patient populations: are special dosing considerations required?. Cleve Clin J Med. 2005;72(suppl):S37–S42
  18. Scholten DJ, Hoedema RM, Scholten SE. A comparison of two different prophylactic dose regimens of low molecular weight heparin in bariatric surgery. Obes Surg. 2002;12:19–24
  19. Simone EP, Madan AK, Tichansky DS, et al. Comparison of two low-molecular-weight heparin dosing regimens for patients undergoing laparoscopic bariatric surgery. Surg Endosc. 2008;22:2392–2395
  20. Borkgren-Okonek MJ, Hart RW, Pantano JE, et al. Enoxaparin thromboprophylaxis in gastric bypass patients: extended duration, dose stratification, and antifactor Xa activity. Surg Obes Relat Dis. 2008;4:625–631
  21. Shepherd MF, Rosborough TK, Schwartz ML. Heparin thromboprophylaxis in gastric bypass surgery. Obes Surg. 2003;13:249–253
  22. Shepherd MF, Rosborough TK, Schwartz ML. Unfractionated heparin infusion for thromboprophylaxis in highest risk gastric bypass surgery. Obes Surg. 2004;14:601–605
  23. Collins TC, Souchek J, Beyth RJ. Benefits of antithrombotic therapy after infrainguinal bypass grafting: a meta-analysis. Am J Med. 2004;117:93–99
  24. Collen JF, Jackson JL, Shorr AF, Moores LK. Prevention of venous thromboembolism in neurosurgery: a metaanalysis. Chest. 2008;134:237–249
  25. Dickinson LD, Miller LD, Patel CP, Gupta SK. Enoxaparin increases the incidence of postoperative intracranial hemorrhage when initiated preoperatively for deep venous thrombosis prophylaxis in patients with brain tumors. Neurosurgery. 1998;43:1074–1079
  26. Quinlan DJ, Eikelboom JW, Dahl OE, et al. Association between asymptomatic deep vein thrombosis detected by venography and symptomatic venous thromboembolism in patients undergoing elective hip or knee surgery. J Thromb Haemost. 2007;5:1438–1443
  27. Kearon C. Natural history of venous thromboembolism. Circulation. 2003;107:I22–I30
  28. Eikelboom JW, Karthikeyan G, Fagel N, Hirsh J. American Association of Orthopedic Surgeons and American College of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: what are the implications for clinicians and patients?. Chest. 2009;135:513–520
  29. White RH, Zhou H, Romano PS. Incidence of symptomatic venous thromboembolism after different elective or urgent surgical procedures. Thromb Haemost. 2003;90:446–455
  30. Spencer FA, Lessard D, Emery C, et al. Venous thromboembolism in the outpatient setting. Arch Intern Med. 2007;167:1471–1475
  31. Agnelli G, Bolis G, Capussotti L, et al. A clinical outcome-based prospective study on venous thromboembolism after cancer surgery: the @RISTOS project. Ann Surg. 2006;243:89–95
  32. Yu HT, Dylan ML, Lin J, Dubois RW. Hospitals' compliance with prophylaxis guidelines for venous thromboembolism. Am J Health Syst Pharm. 2007;64:69–76
  33. Rahme E, Dasgupta K, Burman M, et al. Postdischarge thromboprophylaxis and mortality risk after hip-or knee-replacement surgery. CMAJ. 2008;178:1545–1554
  34. Bottaro FJ, Elizondo MC, Doti C, et al. Efficacy of extended thrombo-prophylaxis in major abdominal surgery: what does the evidence show? (A meta-analysis). Thromb Haemost. 2008;99:1104–1111
  35. Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008;133:454S–545S
  36. Muntz J, Scott DA, Lloyd A, Egger M. Major bleeding rates after prophylaxis against venous thromboembolism: systematic review, meta-analysis, and cost implications. Int J Technol Assess Health Care. 2004;20:405–414
  37. Horlocker TT, Wedel DJ, Benzon H, et al. Regional anesthesia in the anticoagulated patient: defining the risks (the second ASRA Consensus Conference on Neuraxial Anesthesia and Anticoagulation). Reg Anesth Pain Med. 2003;28:172–197
  38. Meyer G, Tamisier D, Sors H, et al. Pulmonary embolectomy: a 20-year experience at one center. Ann Thorac Surg. 1991;51:232–236
  39. Stein PD, Alnas M, Beemath A, Patel NR. Outcome of pulmonary embolectomy. Am J Cardiol. 2007;99:421–423
  40. Torbicki A, Perrier A, Konstantinides S, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J. 2008;29:2276–2315
  41. Eid-Lidt G, Gaspar J, Sandoval J, et al. Combined clot fragmentation and aspiration in patients with acute pulmonary embolism. Chest. 2008;134:54–60
  42. Arixtra [package insert]. Research Triangle Park, NC: GlaxoSmithKline; 2008;
  43. INNOHEP [package insert]. Summit, NJ: Celgene Corporation; 2008;
  44. Fragmin [package insert]. New York: Pfizer Inc; 2007;
  45. Spinler SA, Inverso SM, Cohen M, et al. Safety and efficacy of unfractionated heparin versus enoxaparin in patients who are obese and patients with severe renal impairment: analysis from the ESSENCE and TIMI 11B studies. Am Heart J. 2003;146:33–41
  46. Cestac P, Bagheri H, Lapeyre-Mestre M, et al. Utilisation and safety of low molecular weight heparins: prospective observational study in medical inpatients. Drug Saf. 2003;26:197–207
  47. Turpie A, Bauer K, Eriksson B, Lassen M. Efficacy and safety of fondaparinux in major orthopedic surgery according to the timing of its first administration. Thromb Haemost. 2003;90:364–366
  48. Lim W, Dentali F, Eikelboom JW, Crowther MA. Meta-analysis: low-molecular-weight heparin and bleeding in patients with severe renal insufficiency. Ann Intern Med. 2006;144:673–684
  49. Sanderink GJ, Guimart CG, Ozoux ML, et al. Pharmacokinetics and pharmacodynamics of the prophylactic dose of enoxaparin once daily over 4 days in patients with renal impairment. Thromb Res. 2002;105:225–231
  50. Tincani E, Mannucci C, Casolari B, et al. Safety of dalteparin for the prophylaxis of venous thromboembolism in elderly medical patients with renal insufficiency: a pilot study. Haematologica. 2006;91:976–979
  51. Cadroy Y, Pourrat J, Baladre MF, et al. Delayed elimination of enoxaparin in patients with chronic renal insufficiency. Thromb Res. 1991;63:385–390
  52. Spyropoulos AC. Outpatient-based treatment protocols in the management of venous thromboembolic disease. Am J Manag Care. 2000;6:S1034–S1044
  53. Weitz JI, Hirsh J, Samama MM. New antithrombotic drugs: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008;133:234S–256S
  54. Buller HR, Cohen AT, Davidson B, et al. Extended prophylaxis of venous thromboembolism with idraparinux. N Engl J Med. 2007;357:1105–1112
  55. Buller HR, Cohen AT, Davidson B, et al. Idraparinux versus standard therapy for venous thromboembolic disease. N Engl J Med. 2007;357:1094–1104
  56. Bousser MG, Bouthier J, Buller HR, et al. Comparison of idraparinux with vitamin K antagonists for prevention of thromboembolism in patients with atrial fibrillation: a randomised, open-label, non-inferiority trial. Lancet. 2008;371:315–321
  57. Buller HR, Destors JM, Gallus AS, et al. Idrabiotaparinux, a biotinylated long-acting anticoagulant, in the treatment of deep venous thrombosis (EQUINOX study): safety, efficacy, and reversibility by avidin [abstr]. Blood. 2008;112:32
  58. Haase S. Once daily, oral rivaroxaban for the prevention of venous thromboembolism after total hip or knee replacement: a pooled analysis of the RECORD 1, 2, 3 and 4 trials [abstr 0522]. Paper presented at: European Hematology Association 14th Congress; June 4–7, 2009; Berlin, Germany.
  59. Lassen MR, Davidson BL, Gallus A, et al. The efficacy and safety of apixaban, an oral, direct factor Xa inhibitor, as thromboprophylaxis in patients following total knee replacement. J Thromb Haemost. 2007;5:2368–2375
  60. Lassen MR, Gallus A, Pineo G, et al. Randomized double-blind comparison of apixaban with enoxaparin for thromboprophylaxis after knee replacement: the ADVANCE-1 trial [abstr]. Blood. 2008;112:31
  61. Eriksson BI, Dahl OE, Rosencher N, et al. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial. Lancet. 2007;370:949–956
  62. Eriksson BI, Dahl OE, Rosencher N, et al. Oral dabigatran etexilate vs. subcutaneous enoxaparin for the prevention of venous thromboembolism after total knee replacement: the RE-MODEL randomized trial. J Thromb Haemost. 2007;5:2178–2185
  63. Friedman RJ, Caprini JA, Comp PC, et al. Dabigatran etexilate versus enoxaparin in preventing venous thromboembolism following total knee arthroplasty [abstr]. J Thromb Haemost. 2007;5(suppl):O-W-051

 Dr Muntz is a member of the advisory boards of Boehringer Ingelheim, Johnson & Johnson, and sanofi-aventis; a consultant for Bayer AG, Boehringer Ingelheim GmbH, sanofi-aventis, and Johnson & Johnson; and a member of the speakers' bureau of sanofi-aventis. Dr Michota is a member of the advisory boards of sanofi-aventis, Osaka Pharmaceuticals, Genentech Inc, and Ortho-McNeil/Johnson & Johnson and is a consultant and a member of the speakers' bureau of sanofi-aventis, Osaka Pharmaceuticals, and Genentech Inc.

PII: S0002-9610(09)00646-1

doi: 10.1016/j.amjsurg.2009.10.007

The American Journal of Surgery
Volume 199, Issue 1, Supplement , Pages S11-S20 , January 2010

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