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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Thromboprophylaxis in lower limb amputation surgery.

Monique Magnavita Borba da Fonseca Cerqueira1, Marcos Arêas Marques2,3, Alcides José Araújo Ribeiro4

  • 1Universidade do Estado da Bahia - UNEB, Salvador, BA, Brasil.

Jornal Vascular Brasileiro
|September 17, 2024
PubMed
Summary

Pharmacological thromboprophylaxis practices for lower limb amputation surgery in Brazil are heterogeneous. Many surgeons stratify thrombotic risk but not bleeding risk, indicating a need for standardized guidelines.

Keywords:
amputationdeep vein thrombosishealth services researchpatient safetyprophylaxispulmonary embolism

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Area of Science:

  • Vascular Surgery
  • Thromboprophylaxis
  • Venous Thromboembolism

Background:

  • Lower limb amputation surgery carries a significant risk of venous thromboembolism (VTE).
  • Current evidence suggests that pharmacological thromboprophylaxis is underutilized in patients undergoing this procedure.

Purpose of the Study:

  • To describe the thromboprophylaxis practices of vascular surgeons in Brazil during the perioperative period of lower limb amputation.
  • To analyze the current approaches to VTE prophylaxis in this surgical population.

Main Methods:

  • A cross-sectional, descriptive study was conducted with angiologists and vascular surgeons in Brazil.
  • Data were collected via electronic questionnaires between February and June 2023.

Main Results:

  • 237 surgeons responded; 58.6% stratified thrombotic risk, primarily using the Caprini score (86.3%).
  • Only 27% assessed bleeding risk. Low molecular weight heparin was the preferred agent (85.7%), often at 40 IU/day.
  • Over half (51.15%) prescribed prophylaxis until hospital discharge, with heterogeneity in additional anticoagulant use.

Conclusions:

  • Practices regarding pharmacological thromboprophylaxis for lower limb amputation are diverse.
  • Further research is needed to establish evidence-based guidelines for VTE prophylaxis in this patient group.