Isolated Distal Deep Vein Thrombus Detected before Orthopedic Surgery: Is Preoperative Anticoagulation Preferable?

Autor:	Higo K; Department of Cardiovascular Medicine, Japanese Red Cross Kagoshima Hospital, Kagoshima, Kagoshima, Japan., Tokushige A; Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Okinawa, Japan., Tezuka A; Department of Cardiovascular Medicine, Japanese Red Cross Kagoshima Hospital, Kagoshima, Kagoshima, Japan., Ojima S; Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan., Miyauchi T; Department of Cardiovascular Medicine, Imamura Sogo Hospital, Kagoshima, Kagoshima, Japan., Saihara K; Heart Support K Lab, Kagoshima, Kagoshima, Japan., Sunahara N; Department of Orthopedic Surgery, Japanese Red Cross Kagoshima Hospital, Kagoshima, Kagoshima, Japan., Taketomi E; Department of Orthopedic Surgery, Japanese Red Cross Kagoshima Hospital, Kagoshima, Kagoshima, Japan., Ohishi M; Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan.
Jazyk:	angličtina
Zdroj:	Annals of vascular diseases [Ann Vasc Dis] 2019 Sep 25; Vol. 12 (3), pp. 354-361.
DOI:	10.3400/avd.oa.19-00019
Abstrakt:	Objective : We evaluate the efficacy of anticoagulant administration for isolated distal deep vein thrombus (IDDVT), detected before orthopedic surgery. Materials and Methods : The study included 32 patients diagnosed with IDDVT before orthopedic surgery in our hospital between October 2011 and October 2017. They were divided into two groups: the 'pre- and post-operative therapy group,' who were administered anticoagulants both pre- and post-operatively, and the 'post-operative therapy group,' who were administered anticoagulants only after surgery due to risk of bleeding judged by an orthopedic surgeon. We compared the primary efficacy (change in IDDVT size) between the two groups. Results : The proportion of patients with increased post-operative IDDVT sizes was significantly larger in the post-operatively treated group than in the pre- and post-operatively treated group (44.4% vs. 8.7%, p=0.026). No case demonstrated an IDDVT extension proximal to the popliteal vein or presented with symptomatic pulmonary thromboembolism in this study. Conclusion : Based on our findings, we recommend that, in patients with IDDVT detected prior to orthopedic surgery and administered anticoagulant therapy only after the procedure because of a bleeding risk, a lower limb ultrasonography to re-evaluate the existing deep vein thrombus should be conducted before beginning rehabilitation. Competing Interests: Disclosure StatementThe authors declare no conflict of interest. (Copyright © 2019 Annals of Vascular Diseases.)
Databáze:	MEDLINE
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