Postoperative anticoagulation in vascular surgery--Part two: A summary of lessons learned in our successful discharge...

Postoperative anticoagulation is not an uncommon scenario for patients undergoing vascular procedures. Additional postoperative length of stay (LOS) is necessary to achieve a therapeutic international normalized ratio with traditional protocols using unfractionated heparin. In part one of this 2-part article, low-molecular-weight heparin (LMWH), specifically enoxaparin, was shown to be a safe and effective alternative for anticoagulation after vascular surgical procedures. At the same time, its use can significantly reduce the average postoperative LOS after vascular procedures. This article describes a successful discharge planning experience using the LMWH enoxaparin after vascular procedures. We share our perspective on the role of the various members of the vascular surgical team as implemented in our acute care vascular surgical service clinical setting. Our discussion may offer ideas for consideration by vascular clinicians in their clinical settings.