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dvt Prophylaxis bariatric

C Stroh, N Michel, D Luderer, S Wolff, V Lange, F Köckerling, C Knoll, T Manger
BACKGROUND: Evidence-based data on optimal approach for prophylaxis of deep venous thrombosis (VTE) and pulmonary embolism (PE) in bariatric operations is discussed. Using antithrombotic prophylaxis, weight adjusted the risk of VTE and its complications have to be balanced with the increased bleeding risk. METHODS: Since 2005, the current situation for bariatric surgery has been examined by quality assurance study in Germany. As a prospective multicenter observational study, data on the type, regimen, and time course of VTE prophylaxis were documented...
April 25, 2016: Obesity Surgery
Matthew A Bartlett, Karen F Mauck, Paul R Daniels
Bariatric surgical procedures are now a common method of obesity treatment with established effectiveness. Venous thromboembolism (VTE) events, which include deep vein thrombosis and pulmonary embolism, are an important source of postoperative morbidity and mortality among bariatric surgery patients. Due to an understanding of the frequency and seriousness of these complications, bariatric surgery patients typically receive some method of VTE prophylaxis with lower extremity compression, pharmacologic prophylaxis, or both...
2015: Vascular Health and Risk Management
Davide Imberti, Edoardo Baldini, Matteo Giorgi Pierfranceschi, Alberto Nicolini, Concetto Cartelli, Marco De Paoli, Marcello Boni, Esmeralda Filippucci, Stefano Cariani, Giorgio Bottani
BACKGROUND: The optimal dose of low molecular weight heparin (LMWH) to prevent venous thromboembolism (VTE) after bariatric surgery remains controversial. The aim of this multicentre, open-label, pilot study was to evaluate the efficacy and safety of two different doses of the LMWH parnaparin administered to patients undergoing bariatric surgery. METHODS: Patients were randomised to receive 4,250 IU/day (group A) or 6,400 IU/day (group B) of parnaparin s.c. for 7-11 days...
February 2014: Obesity Surgery
Kavin G Shah, Derry Rajan, Jeffrey Nicastro, Ernesto P Molmenti, Gene Coppa
Bariatric surgery has been demonstrated to be an effective treatment for morbid obesity. The purpose of this study is to investigate the incidence of pre- and post-operative deep venous thrombosis (DVT) in Lap-Band surgical patients. This study group comprised 56 consecutive patients who underwent Lap-Band surgery. Mean age and body mass index were 38 years (range: 18-64 years) and 50.9 kg/m(2) (range: 53-74 kg/m(2)), respectively. All the patients were screened with duplex ultrasonography pre- and post-operatively...
April 2012: Indian Journal of Surgery
Nancy J Birkmeyer, Jonathan F Finks, Wayne J English, Arthur M Carlin, Abdelkader A Hawasli, Jeffrey A Genaw, Michael H Wood, David A Share, John D Birkmeyer
BACKGROUND: The United States Food and Drug Administration recently issued a warning about adverse events in patients receiving inferior vena cava (IVC) filters. OBJECTIVE: To assess relationships between IVC filter insertion and complications while controlling for differences in baseline patient characteristics and medical venous thromboembolism prophylaxis. DESIGN: Propensity-matched cohort study. SETTING: The prospective, statewide, clinical registry of the Michigan Bariatric Surgery Collaborative...
April 2013: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Ben Shamian, Ronald S Chamberlain
The number of patients choosing surgical alternatives for weight reduction continues to increase. Despite common thromboembolic preventive methods, which include perioperative subcutaneous heparin injections, early mobilization, and sequential compression devices, postoperative deep vein thrombosis/pulmonary embolism remains a devastating complication after bariatric surgery. The role prophylactic inferior vena cava (IVC) filters may play in bariatric surgery remains controversial, and this article aims to address the risks and benefits of prophylactic IVC filters in high-risk bariatric patients and suggest an evidence-based algorithm for their use...
December 2012: American Surgeon
Charles Marc Samama, Anne Godier
PURPOSE OF REVIEW: To critically evaluate the benefit/risk ratio of some strategies for venous thromboembolism prophylaxis (VTE) RECENT FINDINGS: A growing body of evidence shows that graduated elastic stockings are not effective in medical patients. Special surgical settings as bariatric surgery deserve attention with a high VTE risk and no evidence-based data with regard to prophylaxis. Extended prophylaxis is being evaluated in these patients, whereas its efficacy has been demonstrated in abdominal and pelvic surgery for cancer...
April 2011: Current Opinion in Anaesthesiology
Conor J Magee, Jonathan Barry, Shafiq Javed, Robert Macadam, David Kerrigan
BACKGROUND: Venous thromboembolism (VTE) after laparoscopic bariatric surgery is a significant cause of morbidity and mortality. The objective of the present study was to study the incidence of symptomatic VTE in extended thromboprophylaxis regimens using dalteparin at an independent hospital in England, United Kingdom. METHODS: A prospective database of all patients undergoing bariatric surgery was retrospectively analyzed. All patients underwent VTE prophylaxis regimen using perioperative and extended postoperative low-molecular-weight heparin (dalteparin 2500 IU preoperatively, followed by 5000 IU daily postoperatively)...
May 2010: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Dimitrios Stefanidis, William S Richardson, Robert D Fanelli et al.
BACKGROUND: The development and implementation of evidence-based clinical practice guidelines involves many challenges. The Society of the American Gastrointestinal and Endoscopic Surgeons (SAGES) has been at the forefront of guideline development for laparoscopic surgery since 1991, providing its membership with guidelines on the clinical application of procedures and the granting of privileges. The objective of this study was to assess the use of SAGES guidelines by its members. METHODS: An electronic survey of SAGES members was conducted via e-mail in August 2007...
December 2010: Surgical Endoscopy
Kylie Lepic, Mark A Crowther
PURPOSE OF REVIEW: Venous thromboembolism is an important complication for patients undergoing surgery. Thromboprophylaxis reduces thromboembolic events. RECENT FINDINGS: In this review we discuss the evidence supporting the use of newer agents for thromboprophylaxis, rivaroxaban and dabigatran etexilate. We will also discuss current thromboprophylaxis options for patients undergoing bariatric surgery, including dose and duration of pharmacological prophylaxis and mechanical methods...
September 2009: Current Opinion in Hematology
Ronald H Clements, Kishore Yellumahanthi, Naveen Ballem, Mary Wesley, Kirby I Bland
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of postoperative mortality in bariatric surgical patients. The aim of this study is to report the rate of VTE and bleeding complications using no prophylactic pharmacologic anticoagulation among patients undergoing laparoscopic Roux-en-Y gastric bypass. STUDY DESIGN: Nine hundred fifty-seven consecutive patients who were older than 18 years, had no history of VTE, and had laparoscopic Roux-en-Y gastric bypass by a single surgeon (RHC) between January 2000 and October 2008 were included...
May 2009: Journal of the American College of Surgeons
Carlos A Barba, Carolyn Harrington, Mark Loewen
BACKGROUND: Venous thromboembolism (VTE) is considered one of the principal causes of morbidity and mortality in patients requiring bariatric surgery. A survey to all members of the American Society for Metabolic and Bariatric Surgery was conducted in 1998 and published in 2000 in the journal "Obesity Surgery." METHODS: A survey was repeated to all physician members of the American Society for Metabolic and Bariatric Surgery to determine the current practices for VTE prophylaxis...
May 2009: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Ioannis Raftopoulos, Carolyn Martindale, Andrea Cronin, Jeffrey Steinberg
BACKGROUND: The effect of extended post-discharge thromboprophylaxis (ETP) on venous thromboembolism (VTE) rates following bariatric surgery (BS) is unknown. METHODS: 308 consecutive patients who underwent BS between 2003 and 2007 and who had > 1 month of follow-up were included. In-hospital-only VTE prophylaxis (group A), or extended 10-day ETP (group B) was used in 132 and 176 patients, respectively. All patients underwent bilateral lower extremity venous Doppler studies (BLEVDS) prior to discharge...
November 2008: Surgical Endoscopy
Aldo L Brasileiro, Fausto Miranda, João E M T M Ettinger, Aldemar A Castro, Guilherme B B Pitta, Liberato K de Moura, Euler Azaro, Marcelo L de Moura, Carlos A B Mello, Edvaldo Fahel, Luiz F P de Figueiredo
BACKGROUND: Lower limbs deep vein thrombosis (DVT) and pulmonary embolism (PE) are major causes of morbidity and mortality and are even higher in bariatric patients. The longer operative time and higher immobility in these patients increase the DVT risk. Although deaths after bariatric surgery have been reported, there is no consensus regarding the prophylaxis of DVT. This study's objective is to determine the incidence of lower limbs DVT in patients submitted to Roux-en-Y-gastric bypass (RYGBP) under prophylaxis by enoxaparin...
January 2008: Obesity Surgery
Maria Laura Cossu, Luca Pilo, Gavino Piseddu, Pier Luigi Tilocca, Franca Cossu, Giuseppe Noya
Patients with morbid obesity who undergo bariatric surgery are usually considered at high risk of developing venous thromboembolism. Considering that deep vein thrombosis is often asymptomatic, primary prevention is the key to reducing morbidity and mortality. Between 1995 and 2003, 151 patients underwent surgery for morbid obesity at the Obesity Surgery Centre-University of Sassari. At the beginning of our experience in this field, in the first 65 cases, prophylaxis of thromboembolism consisted in a single intravenous injection of heparin sodium at the time of induction of anaesthesia...
May 2007: Chirurgia Italiana
John T Paige, Biswanath P Gouda, Vonda Gaitor-Stampley, P Greg Scalia, Teresa E Klainer, William J Raum, Louis F Martin
BACKGROUND: Pulmonary embolism (PE) remains a leading cause of death after Roux-en-Y gastric bypass. Currently, various regimens of low-molecular-weight heparin (LMWH) are used for perioperative deep vein thrombosis (DVT) prophylaxis. Anti-factor Xa (AFXa) has been suggested as a potential marker of LMWH activity. We have developed a perioperative prophylactic DVT regimen for our bariatric patients in which the dosage of LMWH they receive is based on their body mass index (BMI). We looked at whether AFXa levels correlated with bleeding risk...
July 2007: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Denis Halmi, Evgeni Kolesnikov
BACKGROUND: Postoperative pulmonary embolism (PE) is a major source of mortality after bariatric surgery. In conjunction with pharmacologic thromboprophylaxis, lower extremity pneumatic compression devices, and early ambulation, preoperative placement of a retrievable inferior vena cava (IVC) filter may reduce the risk of thromboembolic complications. METHODS: From June 2003 to October 2005, 652 patients underwent mini-open Roux-en-Y gastric bypass. Of the 652 patients, 557 were women and 95 were men...
November 2007: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Giselle G Hamad, Patricia Smith Choban
BACKGROUND: Obese patients undergoing bariatric surgery are at significant risk for venous thromboembolism (VTE). We performed a multicenter, retrospective survey to evaluate the safety and efficacy of enoxaparin for thromboprophylaxis in patients with morbid obesity undergoing primary bariatric surgery. METHODS: From January to December 2002, 668 patients who underwent primary bariatric surgery at 5 centers were analyzed retrospectively. Baseline patient demographics, objectively diagnosed cases of VTE, and bleeding events were recorded...
November 2005: Obesity Surgery
Pavan Atluri, Steven E Raper
BACKGROUND: Patients undergoing bariatric surgery are at risk for deep venous thrombosis (DVT) and fatal pulmonary embolus. In the presence of genetic hypercoagulable disorders, accepted methods of DVT prophylaxis utilizing sequential compression devices and subcutaneous unfractionated heparin may not be adequate to prevent DVT or fatal PE. METHODS AND RESULTS: 3 morbidly obese patients are described who underwent open Roux-en-Y gastric bypass and either had a previous diagnosis of Factor V Leiden or developed thrombosis in the presence of standard prophylaxis...
April 2005: Obesity Surgery
E C Wu, C A Barba
BACKGROUND: Morbidly obese patients undergoing bariatric surgery have commonly been concluded to be at high risk for the development of perioperative venous thromboembolism. Due to its clinically silent nature, primary prevention is the key to reduce morbidity and mortality. There is no clear consensus in the literature regarding the optimum approach to minimize this preventable phenomenon. METHODS: Members of the American Society for Bariatric Surgery were surveyed regarding their current practices in the prophylaxis of venous thromboembolism in their bariatric patients...
February 2000: Obesity Surgery
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