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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Deep venous thrombosis prophylaxis.
1Division of Neurosurgery, University of California at Los Angeles, Los Angeles, CA 90095, USA. PVespa@mednet.ucla.edu
Neurocritical Care
|July 13, 2011
Summary
Preventing deep venous thrombosis after subarachnoid hemorrhage is crucial. Mechanical methods are safe, while unfractionated heparin is effective but risky; low molecular weight heparin increases intracranial hemorrhage risk.
Area of Science:
- Neurology
- Vascular Surgery
- Critical Care Medicine
Background:
- Deep venous thrombosis (DVT) is a risk after subarachnoid hemorrhage (SAH) repair.
- Prophylactic therapy is recommended, but specific guidance is limited.
- Limited data exist on optimal DVT prophylaxis post-SAH.
Purpose of the Study:
- To review the available literature on DVT prophylaxis after SAH repair.
- To evaluate the efficacy and risks of different prophylactic methods.
- To identify gaps in knowledge regarding timing and duration of therapy.
Main Methods:
- An electronic literature search was performed for English-language articles.
- Studies published between 1980 and March 2011 were included.
- A total of 12 articles were reviewed, including original research and meta-analyses.
Main Results:
- DVT incidence varied, with higher rates in studies using ultrasound screening.
- Poor-grade SAH patients face the highest DVT risk.
- Mechanical prophylaxis showed modest efficacy and safety.
- Unfractionated heparin was moderately effective but posed a small ICH risk.
- Low molecular weight heparin was associated with increased intracranial hemorrhage (ICH) risk.
Conclusions:
- Mechanical prophylaxis appears safe and modestly effective for SAH patients.
- Unfractionated heparin offers moderate efficacy with a slight ICH risk.
- Low molecular weight heparin use requires caution due to increased ICH risk.
- More research is needed on optimal timing and duration of DVT prophylaxis after SAH.
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