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Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Published on: July 31, 2016

[Perioperative venous thromboembolism prophylaxis].

Charles-Marc Samama¹

¹Service d'anesthésie-réanimation, Hôtel-Dieu, AP-HP, 75181 Paris Cedex 04. marc.samama@htd.aphp.fr

La Revue Du Praticien

|April 2, 2011

Summary

Venous thromboembolism prophylaxis reduces surgical risk, with mechanical methods as first-line for bleeding patients. Drug therapy enhances effectiveness, but long-term outcomes require further study.

Area of Science:

Medical research
Surgical risk assessment
Pharmacology

Context:

Perioperative management has improved, decreasing surgical risk.
Venous thromboembolism (VTE) prophylaxis benefits are established.
Mechanical prophylaxis is recommended for patients with bleeding risks.

Purpose:

To review current strategies for VTE prophylaxis.
To highlight considerations for drug selection and patient risk stratification.
To discuss the evolving landscape of antithrombotic agents.

Summary:

VTE risk is multifactorial, combining patient and surgical factors.
Mechanical prophylaxis is a primary strategy, especially for high-bleeding-risk patients.
Pharmacological prophylaxis, considering renal function and patient specifics, enhances efficacy.

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Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Published on: July 31, 2016

Extended prophylaxis is recommended for high-risk surgeries like hip replacement and major abdominal procedures.

The clinical significance of distal deep vein thromboses is debated, advocating for clinical endpoints over surrogate venographic ones.

New oral anticoagulants present future challenges regarding monitoring and reversal.

Impact:

Informs clinical practice regarding VTE prophylaxis selection and duration.
Highlights the need for individualized risk assessment and management.
Suggests a shift towards clinical criteria for evaluating prophylaxis effectiveness.
Anticipates changes in VTE prevention strategies with novel oral antithrombotic agents.