Assessment of treatment strategy in high-risk surgical patients

The risk of postoperative venous thromboembolism (VTE) is dependent on the type of surgical procedure and specific characteristics of the patient. Patients with intrinsic factors placing them at higher risk of VTE remain at high risk, even if the procedural risk is low. The identification of factors such as age, obesity, and malignant disease, has made it possible to make a preoperative assessment of risk and ensures that the most appropriate thromboprophylactic regimen is prescribed. Despite the widespread use of prophylaxis, the incidence of VTE is still significant. The investigation and development of new pharmacologic agents, such as hirudins and their recombinant derivatives, may lead to better protection for patients at high or very high risk of VTE.