Extended Low-Molecular Weight Heparin VTE Prophylaxis in the Thoracic Surgery Population--a Randomized Controlled Pilot Study
After any surgery, there is a risk of venous thromboembolism (VTE), including Deep Vein
Thrombosis (DVT) in the major veins of the legs and Pulmonary Embolus (PE) in the lungs.
These clots are usually prevented by the administration of low-molecular-weight heparin, a
blood thinner that prevents clotting. In most surgical specialties like thoracic or vascular
surgery, this treatment is used until patients are discharged from the hospital. However, in
orthopaedic surgery, there is strong evidence that longer term preventative treatment up to
35 days after hospital discharge helps to reduce VTE occurrences. In thoracic surgery, there
is an even greater risk of developing PE because of the surgical stress, the common presence
of cancer and direct damage to blood vessels in the lung during surgery. Despite the
potential utility, the use of extended VTE prevention has never been evaluated in the
thoracic surgery population. If extended treatment prevents clots, more patients will avoid
complications related to VTE. There is currently very limited information available on the
incidence of venous thromboembolism (VTE) in patients undergoing lung cancer resection and
the utility of extended thromboprophylaxis (ET) in this patient population. Furthermore, in
contrast to patients undergoing orthopaedic surgery where ET has become standard of care,
duration of thromboprophylaxis is not well defined in this patient population. Therefore,
there is a clear need to systematically evaluate the effects of extended VTE prophylaxis on
the incidence of VTE in the post-op population.
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