Authors: D Wayne Overby Geoffrey P Kohn Mitchell A Cahan Robert G Dixon Joseph M Stavas Stephan Moll Charles T Burke Karen J Colton Timothy M Farrell
Publish Date: 2009/01/06
Volume: 19, Issue: 4, Pages: 451-455
Abstract
Despite a growing body of evidence guiding appropriate perioperative thromboprophylaxis in the general population few data direct strategies to reduce deep venous thrombosis DVT and pulmonary embolism PE in the morbidly obese We have implemented a novel protocol for venous thromboembolism VTE risk stratification in RouxenY gastric bypass RYGB candidates at our institution which augments clinical assessment with screening for thrombophilias to guide retrievable inferior vena cava IVC filter utilizationA retrospective review of prospectively collected data from patients who underwent primary RYGB between 2001 and 2008 at the University of North Carolina at Chapel Hill was completed During that time clinical assessment of VTE risk was amplified by focused plasma screening for common thrombophilias factors VIII IX and XI ddimer fibrinogen Preoperative prophylactic IVC filters were offered to highrisk patients The database was reviewed for perioperative DVTs PEs and filterrelated complicationsOf 330 patients in 162 attempts 160 had prophylactic IVC filters placed with four complications overall 247 No patient had symptoms of PE during the planned 6week filter period though one had a PE occur immediately after filter removal 063 in contrast five of 170 patients 294 without prophylactic IVC filters presented with symptomatic PE p = 0216 In total 147 9188 prophylactic filters were removed
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