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Venous Thromboembolism – Prophylaxis and Treatment

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Principles of Metabolic Surgery

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Abstract

Venous thromboembolism has long been identified as a major concern in surgical patients. In general surgery, the rate of deep vein thrombosis is about 25% without prophylaxis. In high-risk groups such as patients undergoing knee or hip surgery, the rate of thrombosis without prophylaxis is proven to be around 50%. In patients with spinal cord injury or complicated fracture of the pelvis, rates of up to 75% are reported. In the past few years, accumulating evidence has shown an increased risk of venous thromboembolism also in acutely ill medical patients, with rates being around 20%. These data refer to the detection of thrombosis by technical means and not to clinically overt thrombosis. In prospective studies, rates of venous thromboembolism detected by suitable diagnostic tools are always much higher than rates of thrombosis detected clinically. This finding is simply due to the fact that only a minor fraction of thromboses and even pulmonary embolisms lead to clinical symptoms. If symptoms are present, they are unspecific and possibly related to an alternate underlying cause in most cases. Nevertheless, the sequelae of major concern occur at the same rate in symptomatic and non-symptomatic cases: life-threatening pulmonary embolism, chronic thromboembolic pulmonary hypertension, and post-thrombotic syndrome.

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Authors
  1. Stefan Utzolino MD
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  2. Magnus Kaffarnik MD
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  1. Abt. Allgemein- und Viszeralchirurgie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg

    W. Konrad Karcz  & Oliver Thomusch  & 

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Utzolino, S., Kaffarnik, M. (2012). Venous Thromboembolism – Prophylaxis and Treatment. In: Karcz, W.K., Thomusch, O. (eds) Principles of Metabolic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02411-5_11

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  • DOI: https://doi.org/10.1007/978-3-642-02411-5_11

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