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In Vitro Thrombosis Test for Ventricular Assist Devices
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Variations in Perioperative Thromboprophylaxis Practices: Do the Guidelines Need a Closer Look?
Russell Seth Martins1, Elizabeth Christophel2, Kostantinos Poulikidis1
1Division of Thoracic Surgery, Department of Surgery, Hackensack Meridian Health Network, Hackensack, New Jersey.
Annals of Thoracic Surgery Short Reports
|January 10, 2025
Summary
Most US thoracic surgeons deviate from 2022 guidelines on VTE prophylaxis for cancer patients. Extended postoperative prophylaxis is rarely used, suggesting a need to re-evaluate current practices and explore new agents.
Area of Science:
- Thoracic Surgery
- Oncology
- Vascular Surgery
Background:
- Joint guidelines for perioperative venous thromboembolism (VTE) prophylaxis in thoracic cancer patients were issued by the AATS and ESTS in 2022.
- This study assesses adherence to these guidelines one year post-publication.
Purpose of the Study:
- To evaluate current practices in VTE prophylaxis among US thoracic surgeons.
- To determine the extent of adherence to the 2022 AATS/ESTS guidelines.
Main Methods:
- A survey was conducted among board-certified/eligible thoracic surgeons in the US.
- Data were collected between July and October 2023.
Main Results:
- Over half of 103 surveyed surgeons routinely use preoperative chemical VTE prophylaxis.
- The majority limit postoperative prophylaxis to hospital stay, rarely extending it post-discharge.
- Low-molecular-weight heparin (LMWH) is the preferred agent for extended prophylaxis when used.
Conclusions:
- Most US thoracic surgeons do not routinely prescribe extended postoperative VTE prophylaxis, contrary to 2022 guidelines.
- The need for reevaluation of extended thromboprophylaxis is highlighted due to enhanced recovery in minimally invasive surgery.
- Further research, including RCTs on extended prophylaxis and newer agents like DOACs, is warranted.
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