Last update:
12-Dec-2000

Arch Hellen Med, 17(3), May-June 2000, 273-284

REVIEW

Postoperative deep vein thrombosis

T. PAPALAMPROS, K. KARMANIOLAS
3rd Department of Internal Medicine, NIMTS Hospital, Athens, Greece

Venous thromboembolism (VTE) is a common complication and the main cause of death in patients undergoing major general surgical procedures, especially knee or hip arthroplasty. The high risk of VTE and the severe late sequelae of this disease, the post-thrombotic syndrome, necessitate the use of simple, reliable and rapid diagnostic techniques and appropriate prophylactic measures. This review presents current thinking on the diagnosis and prevention of deep vein thrombosis following surgery (PDVT). It refers to the incidence and pathogenesis of PDVT and includes an analysis of the main methods of diagnosis and prophylaxis. The review focuses on the preventive treatment which, with the experience of many clinical trials and the recent use of hirudin, makes possible the application of effective and safe prophylactic regimens. Such therapeutic schemes include adjusted doses of heparin, low molecular weight heparins (LMWHs), heparin (HMWH or unfractionated) and dihydroergotamine combinations, low doses of warfarin and hirudin. Recent advances in the treatment of PDVT are also summarized.

Key words: Deep vein thrombosis, Heparin, Hirudin.