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Updated: Aug 9, 2026
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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Proximal deep vein thrombosis after hip replacement for oncologic indications
Saminathan S Nathan1, Kristy A Simmons, Patrick P Lin
1Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Summary
Hip replacement surgery for cancer increases deep vein thrombosis risk. Combining mechanical compression with low-molecular-weight heparin significantly reduced deep vein thrombosis rates in oncologic patients.
Area of Science:
- Oncology
- Vascular Surgery
- Thrombosis Research
Background:
- Patients undergoing hip surgery for cancer face a high risk of deep vein thrombosis (DVT).
- A prophylaxis program combining chemical and mechanical methods was implemented to mitigate this risk.
- This study aimed to evaluate the effectiveness of the implemented DVT prevention program.
Purpose of the Study:
- To assess the effectiveness of a combined prophylaxis program in preventing deep vein thrombosis (DVT) in cancer patients undergoing hip replacement.
- To identify risk factors associated with DVT development in this patient population.
Main Methods:
- Eighty-seven cancer patients undergoing hip replacement were studied over two years.
- All patients received intermittent pneumatic compression devices.
- Seventy-eight patients were treated with anticoagulants (low-molecular-weight heparin), while nine were not. Postoperative DVT surveillance used duplex Doppler ultrasonography.
Main Results:
- The overall rate of proximal deep vein thrombosis (DVT) was low (4%) with the combined prophylaxis. One patient not receiving anticoagulation developed a pulmonary embolism.
- Disease location was a significant factor, with higher DVT rates in pelvic and femoral disease compared to hip disease (p < 0.00001).
- Sarcoma patients had a higher incidence of both DVT (p < 0.02) and wound complications (p < 0.001) compared to carcinoma or hematologic malignancies.
Conclusions:
- Combining intermittent pneumatic compression devices with low-molecular-weight heparin prophylaxis is effective in reducing proximal deep vein thrombosis rates in oncologic hip replacement patients.
- Disease location and pathologic type are significant independent factors associated with DVT and wound complications, respectively.
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